Primary Care A Collaborative Practice 5th Edition by Terry Mahan Buttaro – Test Bank

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Test Bank For Primary Care A Collaborative Practice 5th Edition by Terry Mahan Buttaro

 

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Sample Questions 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 1: The Evolving Landscape of Collaborative Practice Test Bank

Multiple Choice

 

 

  1. Which assessments of care providers are performed as part of the Value Based Purchasing initiative?

Select all that apply.

 

  1. Appraising costs per case of care for Medicare patients
  2. Assessing patients’ satisfaction with hospital care
  3. Evaluating available evidence to guide clinical care guidelines
  4. Monitoring mortality rates of all patients with pneumonia
  5. Requiring advanced IT standards and minimum cash reserves

 

 

 

  1. What was an important finding of the Advisory Board survey of 2014 about primary care preferences of patients?

 

  1. Associations with area hospitals
  2. Costs of ambulatory care
  3. Ease of access to care
  4. The ratio of providers to patients

 

 

 

  1. A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1 What is part of this designation?

 

  1. Bonuses based on achievement of benchmarks

 

Test Bank                                                                                                                                          2

 

  1. Care coordination for chronic diseases
  2. Standards for minimum cash reserves
  3. Strict requirements for financial reporting

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 2: Transitional Care Test Bank

Multiple Choice

 

 

  1. To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid Service have implemented which policy?

 

  1. Mandates for communication among primary caregivers and hospitalists
  2. Penalties for failure to perform medication reconciliations at time of discharge
  3. Reduction of payments for patients readmitted within 30 days after discharge
  4. Requirements for written discharge instructions for patients and caregivers

 

 

  1. According to Naylor’s transitional care model, which intervention has resulted in lower costs and fewer rehospitalizations in high-risk older patients?

 

  1. Coordination of post-hospital care by advanced practice nurses
  2. Frequent post-hospital clinic visits with a primary care provider
  3. Inclusion of extended family members in the outpatient plan of care
  4. Telephone follow up by the pharmacist to assess medication compliance

 

 

 

  1. Which approaches are among those recommended by the Agency for Healthcare Research and Quality to improve health literacy in patients?

Select all that apply.

 

  1. Empowering patients and families
  2. Giving written handouts for all teaching

 

Test Bank                                                                                                                                          2

 

  1. Highlighting no more than 7 key points
  2. Repeating the instructions
  3. Supplementing teaching with visual aids

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 3: Translating Research Into Clinical Practice Test Bank

Multiple Choice

 

 

  1. Which is the most appropriate research design for a Level III research study?

 

  1. Epidemiological studies
  2. Experimental design
  3. Qualitative studies
  4. Randomized clinical trials

 

 

 

  1. What is the purpose of clinical research trials in the spectrum of translational research?

 

  1. Adoption of interventions and clinical practices into routine clinical care
  2. Determination of the basis of disease and various treatment options
  3. Examination of safety and effectiveness of various interventions
  4. Exploration of fundamental mechanisms of biology, disease, or behavior

 

 

 

  1. What is the purpose of Level II research?

 

  1. To define characteristics of interest of groups of patients
  2. To demonstrate the effectiveness of an intervention or treatment
  3. To describe relationships among characteristics or variables
  4. To evaluate the nature of relationships between two variables

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 4: The Patient, the Provider, and Primary Care: An Integrated Perspective Test Bank

Multiple Choice

 

 

  1. A patient  takes  glucosamine  chondroitin  to  help  control  osteoarthritis    Which medications, taken in conjunction with this medication, are of concern?

 

  1. Anticholinergic drugs
  2. Beta blocker medications
  3. Blood-thinning agents
  4. Narcotic analgesics

 

 

 

  1. The provider learns that a patient is taking herbal supplements for a variety of What is an important point to discuss with this patient about taking such supplements?

 

  1. Because they are not FDA approved, they are not safe
  2. Dietary supplements are safer than most prescription medications
  3. Many supplements lack clear clinical evidence of efficacy
  4. Supplements should not be taken with prescription medications

 

 

  1. Which dietary supplements have shown some effectiveness in reducing blood pressure in patients with hypertension?

Select all that apply.

 

  1. Chromium picolinate
  2. Cinnamon
  3. CoQ10

 

Test Bank                                                                                                                                          2

 

  1. Garlic extract
  2. L-arginine

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 5: Population-Based Care for Primary Care Providers Test Bank

Multiple Choice

 

 

  1. Which are key components of the Patient-Centered Medical Home? Select all that

 

  1. Access to care
  2. Comprehensive care
  3. Coordination of care
  4. Provision of care by a single provider
  5. Storage of medical records

 

 

 

  1. The chronic care model (CCM) was developed to manage patients with complicated chronic conditions because the traditional acute care model

 

  1. could not provide efficient and cost-effective chronic
  2. did not meet longitudinal health care needs for this
  3. did not offer ambulatory care services for these
  4. put patients and families at the center of

 

 

  1. What are functions of patient registries in the chronic care model? Select all that

 

  1. Alerting providers to medication interactions

 

Test Bank                                                                                                                                          2

 

  1. Identifying appropriate specialists for referral
  2. Recommending routine screenings
  3. Reminding providers about immunizations
  4. Transmitting clinical data about patients

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 6: Health Literacy, Health Care Disparities, and Culturally Responsive Primary Care

 

Test Bank Multiple Choice

 

  1. A primary care provider administers the “Newest Vital Sign” health literacy test to a patient newly diagnosed with a chronic What information is gained by administering this test?

 

  1. Ability to calculate data, along with general knowledge about health
  2. Ease of using technology and understanding of graphic data
  3. Reading comprehension and reception of oral communication
  4. Understanding of and ability to discuss health care concerns

 

 

  1. A female patient who is from the Middle East schedules an appointment in a primary care To provide culturally responsive care, what will the clinic personnel do when meeting this patient for the first time?

 

  1. Ensure that she is seen by a female provider
  2. Include a male family member in discussions about health care
  3. Inquire about the patient’s beliefs about health and treatment
  4. Research middle eastern cultural beliefs about health care

 

 

  1. What is the main reason for using the REALM-SF instrument to evaluate health literacy?

 

  1. It assesses numeracy

 

Test Bank                                                                                                                                          2

 

  1. It enhances patient-provider
  2. It evaluates medical word
  3. It measures technology

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 7: Genetic Considerations in Primary Care Test Bank

Multiple Choice

 

 

  1. A patient expresses concern that she is at risk for breast To best assess the risk for this patient, what is the best initial action?

 

  1. Ask if there is a family history of breast cancer
  2. Gather and record a three-generation pedigree
  3. Order a genetic test for the breast cancer gene
  4. Recommend direct-to-consumer genetic testing

 

 

 

  1. A patient asks about direct-to-consumer (DTC) genetic What will the provider tell the patient?

 

  1. It is not useful for identifying genetic
  2. Much of the information does not predict disease
  3. The results are shared with the patient’s insurance
  4. The results must be interpreted by a

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 8: Risk Management Test Bank

Multiple Choice

 

 

  1. What are some causes for failures or delays in diagnosing patients resulting in malpractice claims?

Select all that apply.

 

  1. Failing to recognize a medication complication
  2. Failing to request appropriate consultations
  3. Improper performance of a treatment
  4. Not acting on diagnostic test results
  5. Ordering a wrong medication

 

 

  1. What is an important part of patient care that can minimize the risk of a formal patient complaint even when a mistake is made?

 

  1. Ensuring informed consent for all procedures
  2. Maintaining effective patient communication
  3. Monitoring patient compliance and adherence
  4. Providing complete documentation of visits

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 9: Adolescent Issues Test Bank

Multiple Choice

 

 

  1. Which behavior is most characteristic of early adolescence?

 

  1. Arguing with parents and teachers
  2. Assimilating adult roles and thinking
  3. Exhibiting fatigue more frequently
  4. Experimenting with sex and risky behaviors

 

 

  1. What is the initial sign of puberty in the adolescent male?

 

  1. Deepening of the voice
  2. Elongation of the penis
  3. Nocturnal emissions
  4. Testicular enlargement

 

 

  1. A parent reports that an adolescent child does well in school but seems to consistently make poor decisions about activities with What will the practitioner recommend as an approach to help the adolescent make better decisions?

 

  1. Correcting the adolescent’s decisions and judgments
  2. Listening without making suggestions about choices
  3. Making decisions for the adolescent to provide guidance
  4. Providing factual information about appropriatebehavior

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 10: LGBTQ Patient Care Test Bank

Multiple Choice

 

 

  1. Which is the most important factor limiting access to health care for sexual and gender minorities?

 

  1. Lack of familial support for SGM members
  2. Laws prohibiting full marriage equality
  3. Risky coping behaviors among SGM members
  4. Social stigma about being in this population

 

 

 

  1. What is the medical diagnostic term used to identify transgender patients?

 

  1. Gender dysphoria
  2. Gender expression disorder
  3. Gender identity disorder
  4. Gender role unconformity

 

.

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 11: Pregnancy and Prenatal Care Test Bank

Multiple Choice

 

 

  1. A woman who is currently pregnant reports that she has had three previous pregnancies: twins delivered at 35 weeks gestation (both living), one at 38 weeks gestation (living), and one miscarriage at 16 weeks How will this be recorded as her G/TPAL in her electronic medical record?

 

  1. G4P:1113 b. G4P:1213 c. G5P:1113 d. G5P:1213

 

 

 

  1. A pregnant woman reports not having had any vaccinations as a child but requests vaccines during her Which vaccines may be given?

Select all that apply.

 

  1. HPV
  2. Inactivated influenza
  3. Live, attenuated influenza
  4. MMR
  5. Tdap
  6. Varicella

 

2

 

  1. A pregnant woman who is overweight has no previous history of hypertension or Her initial screening exam reveals a blood pressure of 140/90 and a fasting blood glucose of 128 mg/dL. What will the practitioner do?

 

  1. Initiate insulin therapy
  2. Monitor blood pressure and fasting blood glucose closely
  3. Prescribe an antihypertensive medication
  4. Refer the patient to a high-risk pregnancy specialist

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 12: Lactation Guidance Test Bank

Multiple Choice

 

 

  1. An infant who has just begun nursing develops What will the provider tell the mother?

 

  1. To decrease the frequency of breastfeeding
  2. To supplement feedings with extra water
  3. To switch to formula until the bilirubin level drops
  4. To use a breast pump to increase her milk supply

 

 

 

  1. The mother of a 3-day-old newborn reports that her infant nurses every 4 hours during the day and sleeps 6 hours at What will the provider recommend?

 

  1. Awakening the baby every 3 hours to nurse
  2. Continuing this schedule until the infant is 6 months old
  3. Ensuring that her infant nurses for 15 to 20 minutes each time
  4. Pumping her breasts to maintain her milk supply

 

 

 

  1. A mother who has been breastfeeding her infant for several weeks develops a fever, breast warmth, and breast What will the provider recommend?

 

  1. Ice packs and decreased frequency of nursing
  2. Ice packs and increased frequency of nursing
  3. Warm packs and decreased frequency of nursing
  4. Warm packs and increased frequency of nursing

 

Test Bank                                                                                                                                          2

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 13: Aging and Common Geriatric Syndromes Test Bank

Multiple Choice

 

 

  1. When prescribing medications to an 80-year-old patient, the provider will

 

  1. begin with higher doses and decrease according to the patient’s
  2. consult the Beers list to help identify potentially problematic
  3. ensure that the patient does not take more than five concurrent
  4. review all patient medications at the annual health maintenance

 

 

 

  1. An 80-year-old woman who lives alone is noted to have a recent weight loss of 5 She appears somewhat confused, according to her daughter, who is concerned that she is developing dementia. The provider learns that the woman still drives, volunteers at the local hospital, and attends a book club with several friends once a month. What is the initial step in evaluating this patient?

 

  1. Obtain a CBC, serum electrolytes, BUN, and glucose
  2. Ordering a CBC, serum ferritin, and TIBC
  3. Referring the patient to a dietician for nutritional evaluation
  4. Referring the patient to a neurologist for evaluation for AD

 

Test Bank                                                                                                                                          2

 

  1. The practitioner is establishing a plan for routine health maintenance for a new female client who is 80 years The client has never smoked and has been in good health. What will the practitioner include in routine care for this patient?

Select all that apply.

 

  1. Annual hypertension screening
  2. Baseline abdominal aorta ultrasound
  3. Colonoscopy every 10 years
  4. One-time hepatitis B vaccine
  5. Pneumovax vaccine if not previously given
  6. Yearly influenza vaccine

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 14: Palliative and End-of Life Care Test Bank

Multiple Choice

 

 

  1. A patient who is near death is exhibiting signs of agitation, anxiety, and intractable When discussing palliative sedation with this patient’s family, what will be discussed?

Select all that apply.

 

  1. The chance that refractory symptoms will be alleviated
  2. The fact that this is an intervention of last resort
  3. The likelihood that the patient will develop dependence on the drugs
  4. The need for informed consent from the patient and family
  5. The possibility that this measure may hasten death

 

 

  1. When should palliative care be initiated by a primary care provider?

 

  1. After an ill patient asks for Hospice services
  2. As part of routine health maintenance
  3. When a patient is diagnosed with a serious disease
  4. When an interdisciplinary team is formed to manage a disease

 

 

  1. When using the “Five Wishes” approach to documenting patient preferences for end-of-life care, the provider will document which types of preferences?

 

Test Bank                                                                                                                                          2

 

Select all that apply.

 

  1. A directive to avoid calling 911 at the time of death
  2. A specific list of treatments the patient does not want
  3. How much information to give various family members
  4. The level of sedation versus alertness the patient desires
  5. The people designated to make care decisions for the patient

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 15: Obesity and Weight Management Test Bank

Multiple Choice

 

 

  1. A woman who is obese has a neck circumference of 5 cm. Which test is necessary to assess for complications of obesity in this patient based on this finding?

 

  1. Electrocardiography
  2. Gallbladder ultrasonography
  3. Mammography
  4. Polysomnography

 

 

 

  1. Which medications are associated with weight gain? Select all that

 

  1. Antibiotics
  2. Antidepressants
  3. Antihistamines
  4. Insulin analogs
  5. Seizure medications

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 16: Lifestyle Management Test Bank

Multiple Choice

 

 

  1. A 60-year-old patient who leads a sedentary lifestyle has expressed an interest in beginning an aerobic exercise What will the provider include when counseling this patient about this program?

 

  1. Begin with a 45 to 60 minute workout
  2. Include a 1 to 2 minute warm up before exercise
  3. Maintain a heart rate between 80 and 128 beats per minute
  4. Stretching should be performed prior to activity

 

 

 

  1. Routine screening blood tests at an annual physical exam reveal a fasting glucose level of 125 mg/dL and a hemoglobin A1C of 2%. What will the provider do, based on these results?

 

  1. Evaluate the patient for impaired glucose tolerance
  2. Reassure the patient that these are normal values
  3. Suggest that the patient begin an exercise program
  4. Tell the patient that these results indicate diabetes

 

 

 

  1. The primary care provider is screening a patient using the CAGE What will the provider include in this assessment?

Select all that apply.

 

  1. Number of times per week eaten in restaurants

 

Test Bank                                                                                                                                          2

 

  1. Sodium and sugar intake
  2. Sources of daily dairy intake
  3. Total number of servings of fruits and vegetables
  4. Types of meats and proteins

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 17: Routine Health Screening and Immunizations Test Bank

Multiple Choice

 

 

  1. A 50-year-old female patient has a blood pressure of 118/72 mm Hg, a negative family history for breast and ovarian cancer, a normal Pap smear 2 years prior, and a Framingham risk screening within normal Which should be part of this patient’s routine annual well-patient exams?

 

  1. Bone mineral density screening
  2. Breast cancer screening and mammogram
  3. Cervical cancer screening with a Pap test
  4. Lipid screening and cholesterol tests

 

 

 

  1. A 55-year-old patient who had influenza in the previous influenza season asks about the flu What will the provider tell the patient?

 

  1. Having influenza vaccine confers lifetime immunity
  2. The FluMist vaccine may be used each year
  3. The Fluzone High-Dose vaccine is recommended
  4. The trivalent influenza vaccine is indicated annually

 

 

 

  1. A 60-year-old patient with a previous history of shingles asks about the herpes zoster What will the provider recommend?

 

Test Bank                                                                                                                                          2

 

  1. A series of two herpes zoster vaccinations
  2. A single dose of herpes zoster vaccine
  3. No herpes zoster vaccine is necessary
  4. Prophylactic vaccination if exposed to chicken pox

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 18: Principles of Occupational and Environmental Health in Primary Care Test Bank

Multiple Choice

 

 

  1. A patient who has a history of working around asbestos and silica fibers is concerned about developing lung The primary care provider determines that the patient has a previous history of asthma as a child and currently has frequent episodes of bronchitis. A physical examination is normal and pulmonary function tests and radiographs are negative. What action is correct?

 

  1. Reassure the patient about the normal findings
  2. Refer the patient to an occupational health specialist
  3. Request a workplace environmental assessment
  4. Suggest that the patient follow up with a pulmonologist

 

 

 

  1. During a pre-placement screening for a person hired for a job requiring heavy lifting, a primary care provider notes that the new employee has environmental allergies, a history of GERD, recurrent eczema, a previous history of an ankle fracture, and normal lower back strength and A urine drug screen is negative. What will be included in the report to the employer?

Select all that apply.

 

  1. GERD history
  2. History of allergies and eczema
  3. History of ankle fracture
  4. Lower back screening results
  5. Urine drug screening results

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 19: College Health Test Bank

Multiple Choice

 

 

  1. A female freshman college student tells the primary care provider at the student health center that she has a history of anorexia nervosa that has been well-controlled for several What will the provider recommend for this student?

 

  1. Dietary counseling
  2. Participation in sports
  3. Regular weight assessments
  4. Stress management strategies

 

 

 

  1. A female college student seeks information about emergency What is the most important part of the assessment of this patient?

 

  1. Cultural considerations for use of contraception
  2. Feelings of guilt about a possible pregnancy
  3. Possible concerns about confidentiality
  4. The female’s sense of control in sexual situations

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 20: Health Care of the International Traveler Test Bank

Multiple Choice

 

 

  1. An international  traveler  plans  to  travel  to  Kenya  in  sub-Saharan    Which  is  an important disease precaution for this person?

 

  1. Carrying chloroquine to take as needed
  2. Starting prophylactic doxycycline before travel
  3. Taking precautions against Chikungunya fever
  4. Understanding how Ebola virus is transmitted

 

 

 

  1. A patient returns home from travel in Africa and experiences chronic, non-bloody The patient reports frequent bloating and flatulence with a “rotten egg” smell. What is the treatment for this type of diarrhea?

 

  1. Azithromycin
  2. Ciprofloxacin
  3. Metronidazole
  4. Rifampin

 

 

  1. A patient who is planning international travel to a developing country asks the provider about Which is true about pre-travel vaccines?

 

Test Bank                                                                                                                                          2

 

  1. Country-specific guidelines are provided by individual
  2. Malaria vaccine is the most important vaccine for worldwide
  3. Requirements should be reviewed at least 6 to 8 weeks prior to
  4. There are at least five required vaccines for entry into certain

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 21: Presurgical Clearance Test Bank

Multiple Choice

 

 

  1. Which factors  determine  which  diagnostic  tests  should  be  performed  in  a  presurgical clearance evaluation?

Select all that apply.

 

  1. Patient’s age
  2. Patient’s comorbidities
  3. Previous surgeries
  4. Surgeon’s preference
  5. Type of anesthetic agent planned

 

 

 

  1. Which patient should have pulmonary function testing as part of the presurgical exam?

 

  1. A patient older than 60 years of age
  2. A patient undergoing major intra-thoracic surgery
  3. A patient with a history of pneumonia in the last 2 years
  4. A patient with diabetes and morbid obesity

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 22: Preparticipation Sports Physical Test Bank

Multiple Choice

 

 

  1. During a pre-participation sports physical, the examiner notes a difference in strength of the patient’s radial and femoral pulses with the femoral pulses being What will the provider do?

 

  1. Evaluate for orthostatic hypotension
  2. Obtain Doppler studies of lower extremity circulation
  3. Reassure the patient that this is a normal finding
  4. Refer the patient for a cardiologic exam

 

 

 

  1. An overweight adolescent who takes metformin has type 2 diabetes with a HgA1c of 5% and asks about sports participation. What will the provider recommend?

 

  1. Losing weight prior to initiating sports participation
  2. Participation in strenuous sports to help with weight loss
  3. Referral to the endocrinologist for sports clearance
  4. Switching to insulin therapy prior to participation

 

 

 

  1. A high-school adolescent is being screened for fitness before participating in The adolescent has a normal examination and the examiner notes S1 and S2 heart sounds without murmur, normal blood pressure, and equal pulses. The parent reports that the adolescent’s father has a history or Wolff-Parkinson-White syndrome, which has been treated. What will the provider do?

 

  1. Clear the adolescent to play sports

 

Test Bank                                                                                                                                          2

 

  1. Perform an electrocardiogram
  2. Refer the adolescent to a cardiologist
  3. Tell the adolescent that sports are not allowed

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 23: Disaster/Emergency Preparedness and Response in Primary Care Test Bank

Multiple Choice

 

 

  1. What is included in the mitigation phase of emergency management?

 

  1. Debriefing and review
  2. Drills and exercises
  3. Identification of risks
  4. Use of Incident Command System

 

 

  1. A primary care office develops a plan for what to do in case of a fire in the As part of the plan, two people are to take charge in case of this emergency. Which phase of emergency planning does this represent?

 

  1. Mitigation
  2. Preparedness
  3. Response
  4. Recovery

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 24: Acute Bronchospasm Test Bank

Multiple Choice

 

 

  1. A patient with asthma has been given three bronchodilator treatments but continues to have wheezing and shortness of The nurse caring for the patient notes an oxygen saturation of 90% on room air. What action is indicated?

 

  1. Administer oxygen and continue to monitor the patient
  2. Contact the respiratory therapist to administer another treatment
  3. Notify the patient’s physician immediately
  4. Reassure the patient that the treatments will take effect soon

 

 

 

  1. Which clinical  findings  are  worrisome  in  a  patient  experiencing  acute  bronchospasm, requiring immediate treatment?

Select all that apply.

 

  1. A silent chest after previously wheezing
  2. Decreasing blood pressure
  3. Presence of an urticarial rash
  4. Pulsus paradoxus of 10 mm Hg
  5. Wheezing on both inspiration and expiration

 

 

  1. Which symptom in a patient with asthma indicates severe bronchospasm?

 

Test Bank                                                                                                                                          2

 

  1. Breathlessness with minimal activity or eating
  2. Pausing to breathe while attempting to talk
  3. Repetitive, spasmodic coughing at night
  4. Wheezing after exposure to a trigger

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 25: Anaphylaxis Test Bank

Multiple Choice

 

 

  1. A child with no previous history of asthma is brought to the emergency department with wheezing, stridor, and shortness of When the child is started on oxygen and given a nebulized bronchodilator treatment, the treatment team notes a wheal and flare rash on the child’s trunk. What medication will be given immediately?

 

  1. Inhaled racemic epinephrine
  2. Intramuscular epinephrine
  3. Intravenous diphenhydramine
  4. Intravenous ranitidine

 

 

 

  1. A man self-administers epinephrine using an Epi-Pen after experiencing a bee sting and developing angioedema and What should the man do next?

 

  1. Obtain transport to an emergency department immediately
  2. Repeat the epinephrine dose if needed and notify a physician of the episode
  3. Resume normal activity if symptom free after 30 to 60 minutes
  4. Take oral diphenhydramine and report any symptoms to a provider

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 26: Bites and Stings Test Bank

Multiple Choice

 

 

  1. A patient is seen in the emergency department after experiencing a spider The spider is in a jar and is less than one inch in size, yellow-brown, and has a violin-shaped marking on its back. Depending on the patient’s symptoms, which treatments and diagnostic evaluations may be ordered?

Select all that apply.

 

  1. Airway management
  2. An acute abdominal series
  3. Antivenom therapy
  4. CBC, BUN, electrolytes, and creatinine
  5. Coagulation studies
  6. Tetanus prophylaxis

 

 

 

  1. A child experiences a snake bite while camping and is seen in the emergency The child’s parents are not able to identify the type of snake. An inspection of the site reveals two puncture wounds on the child’s arm with no swelling or erythema at the site. The child has normal vital signs. Which treatment is indicated?

 

  1. Administering antivenom and observing the child for 24 to 48 hours
  2. Cleaning the wound, giving tetanus prophylaxis, and observing for 12 hours
  3. Performing a type and cross match of the child’s blood
  4. Referral to a surgeon for incision and suction of the wound

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 27: Bradycardia and Tachycardia Test Bank

Multiple Choice

 

 

  1. A patient reports heart palpitations but no other symptoms and has no prior history of cardiovascular The clinic provider performs an electrocardiogram and notes atrial fibrillation and a heart rate of 120 beats per minute. Which is the initial course of action in treating this patient?

 

  1. Administer atenolol intravenously
  2. Admit to the hospital for urgent cardioversion
  3. Refer the patient to a cardiologist
  4. Transport the patient to the ED by ambulance

 

 

  1. A patient who takes a beta blocker medication is in the emergency department with syncope, shortness of breath, and A cardiac monitor reveals a heart rate of 35 beats per minute. Which medication may be used to stabilize this patient?

 

  1. Adenosine
  2. Amiodarone
  3. Atropine
  4. Epinephrine

 

 

Test Bank                                                                                                                                          2

 

  1. Which cardiac  arrhythmia  in  an  unstable  patient  requires  unsynchronized  shocks,  or defibrillation?

 

  1. Atrial fibrillation
  2. Atrial flutter
  3. Monomorphic ventricular tachycardia
  4. Polymorphic ventricular tachycardia

 

ANS:  D

Polymorphic ventricular tachycardia should be treated as ventricular fibrillation with unsynchronized shocks. The other arrhythmias are treated with synchronized cardioversion. REF: Box 27-1: Cardioversion and defibrillation of unstable patients with tachycardia

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 28: Cardiac Arrest Test Bank

Multiple Choice

 

 

  1. Current American Heart Association (AHA) recommendations include: Select all that

 

  1. A compression depth of 1½ inches or more on an adult
  2. A rate of 100 compressions per minute at a minimum
  3. Rescue breaths given during 2 seconds to allow full chest rise
  4. Untrained rescuers giving compressions without breaths
  5. Using a ratio of 2 rescue breaths to 30 compressions

 

 

 

  1. The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because most victims have which arrhythmia?

 

  1. Atrial fibrillation
  2. Atrial flutter
  3. Ventricular fibrillation
  4. Ventricular tachycardia

 

 

  1. A health care provider in a clinic finds a patient in a room, unresponsive and Which sign should be used to identify the need to initiate cardiopulmonary resuscitation (CPR)?

 

  1. Assessment of gasping breaths or not breathing
  2. Determination of pulselessness or bradycardia
  3. Evaluation of peripheral perfusion and level of consciousness

 

Test Bank                                                                                                                                          2

  1. Obtaining a history of previous myocardial infarction

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 29: Chemical Exposure Test Bank

Multiple Choice

 

 

  1. What is true when considering activated charcoal for gastrointestinal decontamination to treat a toxic substance ingestion?

 

  1. It acts by enhancing gastric motility to reduce
  2. It is administered only through a nasogastric
  3. It may be used when petroleum distillates are
  4. It must be administered within 60 minutes of

 

 

 

  1. A lawn maintenance worker is brought to the emergency department after an accident in which a large amount of pesticide was sprayed all over his He is able to relate the details of the accident to the emergency department personnel. What is the priority treatment on admission?

 

  1. Administer intravenous diphenhydramine and possibly epinephrine
  2. Contact the Poison Control center to ask about appropriate antidotes
  3. Place on a cardiorespiratory monitor and establish intravenous access
  4. Remove the patient’s clothing and irrigate the skin for 15 to 30 minutes

 

 

 

  1. A child is brought to the emergency department because a grandparent suspects ingestion of a tricyclic antidepressant medication found in the What symptoms will the ED professionals expect to observe if this is the case?

Select all that apply.

 

  1. Excessive salivation
  2. Flushed skin
  3. Hallucinations
  4. Hypothermia
  5. Mydriasis
  6. Urinary frequency

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 30: Electrical Injuries Test Bank

Multiple Choice

 

 

  1. What is true about electrical injuries? Select all that

 

  1. Alternating current causes tetanic skeletal muscle
  2. Direct current is more dangerous than alternating
  3. Electrical injury causes more tissue necrosis in nerves than other
  4. Lightning is less lethal because the duration of electrical strike is
  5. Low-voltage contact has no potential to be

 

 

  1. An adolescent male has an electrical injury from a high-voltage wire after climbing a Which initial diagnostic test is necessary?

 

  1. 12-lead electrocardiogram
  2. Cervical spine radiography
  3. Complete blood count and electrolytes
  4. Creatine kinase and myoglobin level

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 31: Environmental Allergies Test Bank

Multiple Choice

 

 

  1. When performing diagnostic tests to determine which environmental allergens cause symptoms in an atopic patient, which aspects of scratch testing are preferable to other methods?

Select all that apply.

 

  1. It has a lower potential for
  2. It is more
  3. It is
  4. It produces more rapid
  5. It requires a stepwise

 

 

 

  1. Which immunoglobulin  is  responsible  for  initiating  the  allergic  cascade  in  susceptible individuals who are exposed to allergens?

 

  1. IgG
  2. IgA
  3. IgM
  4. IgE

 

 

 

  1. Which food allergies in children may be outgrown in the first decade of life? Select all that

 

  1. Egg allergy
  2. Fish allergy
  3. Milk allergy
  4. Nut allergy

 

Test Bank                                                                                                                                          2

  1. Shell fish allergy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 32: Head Trauma Test Bank

Multiple Choice

 

 

  1. A patient is in the emergency department after sustaining a blow to the head in a motor vehicle The patient’s Glasgow Coma score is 14 and the patient is drowsy. The patient has a small amount of blood in one external auditory canal. Which is a priority in diagnosing the extent of injury in this patient?

 

  1. Close monitoring of pulse, respiration, and oxygenation
  2. Continued assessment of neurological status
  3. Magnetic resonance imaging of the head
  4. Non-enhanced computed tomography of the head

 

 

 

  1. A patient who sustained a head injury has a Glasgow Coma score of The patient’s spouse reported that the patient lost consciousness for approximately 7 minutes after falling down the stairs. A head CT does not reveal brain lesions. Which treatment is indicated?

 

  1. Admission to the hospital with a neurosurgical evaluation
  2. Continued observation in the emergency department until stability is ensured
  3. Discharge to home with close observation by the patient’s spouse for 24 hours
  4. Dismissal to home with a referral for follow up with a neurologist

 

 

 

  1. A patient is brought to the emergency department after being hit in the head with a The patient is awake and talking, but is confused and disoriented and does not obey simple commands. The patient is able to point to the area of pain and opens eyes only when

 

Test Bank                                                                                                                                          2

 

commanded  to  do  so.  Bystanders  report  a  period  of  unconsciousness  lasting  almost  5 minutes. Which severity of traumatic brain injury is likely?

 

  1. Normal
  2. Mild
  3. Moderate
  4. Severe

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 33: Hypotension Test Bank

Multiple Choice

 

 

  1. A young adult patient is being treated for hypertension and is noted to have a resting blood pressure of 135/88 mm Hg just after finishing a After standing, the patient has a blood pressure of 115/70 mm Hg. What is the likely cause of this change in blood pressure?

 

  1. A hyperglycemic episode
  2. Antihypertensive medications
  3. Neurogenic orthostatic hypotension
  4. Postpriandal hypotension

 

 

 

  1. An elderly patient who has orthostatic hypotension secondary to antihypertensive medications is noted to have a drop in systolic blood pressure of 25 mm Which intervention is important for this patient?

 

  1. Administration of intravenous fluids
  2. Close monitoring cardiorespiratory status
  3. Initiation of a fall risk protocol
  4. Withholding antihypertensive medications

 

 

 

  1. An older patient develops orthostatic hypotension secondary to an antihypertensive medication and asks what measures can be taken to minimize this What will the provider recommend?

Select all that apply.

 

Test Bank                                                                                                                                          2

 

  1. Crossing the legs when standing up
  2. Custom-fitted elastic stockings
  3. Discontinuation of the medication
  4. Increased physical activity
  5. Performing the Valsalva maneuver

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 34: Poisoning Test Bank

Multiple Choice

 

 

  1. A patient who ingested a bottle of acetaminophen tablets is brought to the emergency Which treatment is indicated?

 

  1. Flumazenil
  2. N-acetylcysteine
  3. Naloxone
  4. Supportive care only

 

 

 

  1. Several groups of college students arrive in the emergency department reporting severe gastrointestinal symptoms after leaving a fraternity After stabilizing these patients, a priority for the emergency department personnel is to

 

  1. contact the fraternity to determine whether others are
  2. isolate the patients to prevent spread of
  3. notify the local health department about this
  4. obtain histories from the patients about illicit drug

 

 

 

  1. What is the first priority in emergency management of a biological terrorism attack?

 

  1. Basic life support

 

Test Bank                                                                                                                                          2

 

  1. Communication with authorities
  2. Containing the exposures
  3. Informing the public of the risk

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 35: Sexual Assault Test Bank

Multiple Choice

 

 

  1. A patient who was sexually assaulted one month prior tells her provider that she is concerned about contracting When is it appropriate to perform testing?

 

  1. Immediately and then every 6 months for the first year
  2. Immediately with definitive results
  3. In two weeks and then 3 to 6 months after the assault
  4. Three to 6 months after the assault

 

 

 

  1. During a health maintenance examination, 17-year-old female reports having been raped repeatedly at a college party during the previous semester and tells the practitioner that she did not seek help at the Which action is a priority for the primary care provider?

 

  1. Recommending counseling at a local mental health center
  2. Referring the patient to the emergency department for STI testing
  3. Reporting the alleged assault to law enforcement
  4. Suggesting that the patient report the incident to the school

 

 

  1. When beginning a health maintenance exam, the health care provider learns that an adult patient has been sexually assaulted the previous What is the initial responsibility of the provider?

 

  1. Notify the police and encourage the patient to press criminal charges

 

Test Bank                                                                                                                                          2

 

  1. Perform a thorough gynecological exam and obtain cultures
  2. Question the patient about the events surrounding the assault
  3. Refer the patient to the emergency department for a forensic examination

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 36: Syncope Test Bank

Multiple Choice

 

 

  1. Which tests are indicated as part of the initial evaluation for women of childbearing age who report syncope?

Select all that apply.

 

  1. 12-lead electrocardiogram
  2. Cardiac enzyme levels
  3. Complete blood count
  4. Electroencephalogram
  5. Serum glucose testing

 

 

 

  1. A healthy 20-year-old patient reports having had 1 or 2 episodes of syncope without loss of Which is the most likely type of syncope in this patient?

 

  1. Cardiac
  2. Neurogenic
  3. Orthostatic hypotensive
  4. Reflex syncope

 

 

 

  1. An elderly patient reports experiencing syncope each morning when getting out of Which assessment will the  health  care provider  perform  first to  evaluate  this patient’s symptoms?

 

  1. Cardiac enzyme levels
  2. Electroencephalogram

 

Test Bank                                                                                                                                          2

 

  1. Fasting blood glucose
  2. Orthostatic blood pressures

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 37: Thermal Injuries Test Bank

Multiple Choice

 

 

  1. A child is brought to the emergency department after getting lost while camping on a cold, rainy The child is lethargic on admission. The cardiorespiratory monitor shows a normal heart rate and rhythm, a respiratory rate of 8 to 10 breaths per minute, and a normal blood pressure. The assessment reveals erythema and edema of the child’s hands and feet. What treatments are indicated?

Select all that apply.

 

  1. Administer antibiotics
  2. Apply warmed blankets
  3. Elevate the child’s extremities
  4. Massage the hands and feet
  5. Remove all clothing

 

 

 

  1. A patient is brought to a clinic after fainting while working outdoors on a hot The patient has slurred speech and headache and has a temperature of 104° F. What will the provider do?

 

  1. Administer antipyretic medications to reduce the temperature
  2. Administer intravenous fluids in the clinic and monitoring response
  3. Rehydrate the patient with oral fluids containing electrolytes
  4. Transport the patient to the emergency department

 

2

 

  1. A provider attending a soccer match on a hot day is assisting a player who feels hot and appears dehydrated, but who is alert and What does the provider suspect?

 

  1. Heat cramps
  2. Heat exhaustion
  3. Heat stroke
  4. Heat syncope

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 38: Examination of the Skin and Approach to Diagnosis of Skin Disorders Test Bank

Multiple Choice

 

 

  1. When examining a patient’s skin, a practitioner uses dermoscopy in order to Select all that

 

  1. accentuate changes in color of pathologic lesions by
  2. assess changes in pigmentation throughout various
  3. determine whether lesion borders are regular or
  4. differentiate fluid masses from cystic masses in the
  5. visualize skin fissures, hair follicles, and pores in

 

 

 

  1. A primary care provider is performing a Tzanck test to evaluate possible herpes simplex To attain accurate results, the provider will

 

  1. blanch the lesions while examining them with a magnifying
  2. gently scrape the lesions with a scalpel onto a
  3. perform a gram stain of exudate from the
  4. remove the top of the vesicles and obtain fluid from the

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 39: Surgical Office Procedures Test Bank

Multiple Choice

 

 

  1. A provider is preparing to administer electrocautery to a patient who has several seborrheic The patient tells the provider that he has a pacemaker. Which action is correct?

 

  1. Administer the electrocautery per the usual protocol
  2. Apply electrocautery in short burst at low voltage
  3. Refer the patient to a dermatologist for removal
  4. Suggest another method for removal of the lesions

 

 

 

  1. A patient has molluscum contagiosum and the provider elects to use cryosurgery to remove the How will the provider administer this procedure?

 

  1. Apply one freeze-thaw cycle to each lesion
  2. Apply two or more freeze-thaw cycles to each lesion
  3. Apply until the freeze spreads laterally 1 mm from the lesion edges
  4. Apply until the freeze spreads laterally 4 mm from the lesion edges

 

 

 

  1. Which type of office surgical procedure warrants sterile technique?

 

  1. Curettage
  2. Punch biopsy
  3. Scissor excision
  4. Shavebiopsy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 40: Principles of Dermatologic Therapy Test Bank

Multiple Choice

 

 

  1. An infant has atopic dermatitis and seborrheic dermatitis with lesions on the forehead and along the scalp Which is correct when prescribing a corticosteroid medication to treat this condition?

 

  1. Initiate treatment with 1% triamcinolone acetonide (Kenalog lotion)
  2. Monitor the infant closely for systemic adverse effects during use
  3. Place an occlusive dressing over the medication after application
  4. Prescribe 05% fluocinonide (Lidex-E Cream) to apply liberally

 

 

 

  1. When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug?

 

  1. Apply a thick layer of medication over the affected area
  2. Place an occlusive dressing over the medication
  3. Put cool compresses over the affected area after application
  4. Use a lotion or cream instead of an ointment preparation

 

 

  1. A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the Which vehicle type will the provider choose when prescribing this medication?

 

Test Bank                                                                                                                                          2

 

 

  1. Cream
  2. Gel
  3. Ointment
  4. Powder

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 41: Screening for Skin Cancer Test Bank

Multiple Choice

 

 

  1. Curing a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient’s nose. What will the provider do?

 

  1. Consult with a dermatologist about possible melanoma
  2. Reassure the patient that this is a benign lesion
  3. Refer the patient for possible electrodessication and curettage
  4. Tell the patient this is likely a squamous cell carcinoma

 

 

 

  1. What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion?

 

  1. Excisional biopsy
  2. Punch biopsy
  3. Shave biopsy
  4. Wide excision

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 42: Acne Vulgaris Test Bank

Multiple Choice

 

 

  1. A patient has acne and the provider notes lesions on half of the face, some nodules, and two scarred areas. Which treatment will be prescribed?

 

  1. Oral clindamycin for 6 to 8 weeks
  2. Oral isotretinoin
  3. Topical benzoyl peroxide and clindamycin
  4. Topical erythromycin

 

 

 

  1. When counseling a patient with rosacea about management of this condition, the provider may recommend

Select all that apply.

 

  1. applying a topical
  2. avoiding makeup.
  3. avoiding oil-based
  4. eliminating spicy
  5. exposing the skin to
  6. using topical

 

 

  1. A provider is considering an oral contraceptive medication to treat acne in an adolescent female. Which is an important consideration when prescribing this drug?

 

  1. A progesterone-only contraceptive is most beneficial for treating

 

Test Bank                                                                                                                                                2

 

  1. Combined oral contraceptives are effective for non-inflammatory acne
  2. Oral contraceptives are effective because of their androgen enhancing
  3. Yaz, Ortho Tri-Cyclen, and Estrostep are approved for acne

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 43: Alopecia Test Bank

Multiple Choice

 

 

  1. A patient is in the clinic with patches of hair loss. The provider notes several well- demarcated patches on the scalp and eyebrows without areas of inflammation and several hairs within the patch with thinner shafts near the scalp. Based on these findings, which type of alopecia is most likely?

 

  1. Alopecia areata
  2. Anagen effluvium
  3. Cicatricial alopecia
  4. Telogen effluvium

 

 

 

  1. A patient with alopecia is noted to have scaling on the affected areas of the scalp. Which confirmatory test(s) will the provider order?

 

  1. Examination of scalp scrapings with potassium hydroxide
  2. Grasping and pulling on a few dozen hairs
  3. Serum iron studies and a complete blood count
  4. Venereal Disease Research Laboratory (VDRL) test

 

 

 

  1. A female patient is diagnosed with androgenetic alopecia. Which medication will the provider order?

 

  1. Anthralin
  2. Cyclosporine

 

Test Bank                                                                                                                                                2

 

  1. Finasteride
  2. Minoxidil

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 44: Animal and Human Bites Test Bank

Multiple Choice

 

 

  1. Which type of bite is generally closed by delayed primary closure? Select all that

 

  1. Bites to the face
  2. Bites to the hand
  3. Deep puncture wounds
  4. Dog bites on an arm
  5. Wounds 8 hours old

 

 

 

  1. A patient has been bitten by a dog and has sustained several puncture wounds near the thumb of one hand. The patient is able to move all fingers and the bleeding has stopped. What is the correct treatment for this patient?

 

  1. Begin rabies and tetanus prophylaxis and bandage the wound
  2. Clean the wound thoroughly and order a topical antibiotic
  3. Obtain a physician consultation for evaluation and treatment
  4. Prescribe oral antibiotics and have the patient follow up in a few days

 

 

 

  1. A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury?

 

  1. Possible exposure to rabies virus
  2. Potential septic arthritis or osteomyelitis

 

Test Bank                                                                                                                                                2

 

  1. Sepsis from Capnocytophaga canimorsus infection
  2. Transmission of human immunodeficiency virus

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 45: Bullous Pemphigoid Test Bank

Multiple Choice

 

 

  1. An elderly adult patient with bullous pemphigoid is prescribed oral prednisone and hydroxyzine to manage symptoms. Which medication side effect is of immediate concern for this patient?

 

  1. Osteoporosis
  2. Pruritis
  3. Sedation
  4. Weight gain

 

 

 

  1. A patient is newly diagnosed with bullous pemphigoid and has moderate to severe itching. The provider orders a topical corticosteroid will discuss which potential complication with this patient?

 

  1. Bone marrow suppression
  2. Developing systemic lesions
  3. Secondary infection
  4. Spread of disease to others

 

 

 

  1. When assisting with a skin biopsy of a patient suspected of having bullous pemphigoid lesions, the practitioner will

 

  1. avoid contact with the infected
  2. elicit a positive Nikolsky sign to confirm the
  3. perform direct immunofluorescence

 

Test Bank                                                                                                                                                2

 

  1. prevent spread of the lesions to other areas of the

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 46: Burns (Minor) Test Bank

Multiple Choice

 

 

  1. A patient comes to the clinic after being splashed by boiling water while cooking. The patient has partial thickness burns on both forearms, the neck, and the chin. What will the provider do?

 

  1. Clean and dress the burn wounds
  2. Order a CBC, glucose, and electrolytes
  3. Perform a chest radiograph
  4. Refer the patient to the emergency department

 

 

 

  1. A patient suffers chemical burns on both arms after a spill at work. What is the initial action by the providers in the emergency department?

 

  1. Begin aggressive irrigation of the site
  2. Contact the poison control center
  3. Remove the offending chemical and garments
  4. Request the Material Safety Data information

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 47: Cellulitis Test Bank

Multiple Choice

 

 

  1. A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient?

 

  1. Apply moist heat until symptoms resolve
  2. Begin treatment with amoxicillin-clavulanate
  3. Prescribe oral clindamycin
  4. Wait for culture results before ordering an antibiotic

 

 

 

  1. A previously healthy patient has an area of inflammation on one leg which has well- demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection?

 

  1. Amoxicillin-clavulanate
  2. Clindamycin
  3. Doxycycline
  4. Sulfamethoxazole-trimethoprim

 

 

 

  1. A child has vesiculopustular lesions around the nose and mouth with areas of honey-colored crusts. The provider notes a few similar lesions on the child’s hands and legs. Which treatment is appropriate for this child?

 

  1. Amoxicillin-clavulanate

 

Test Bank                                                                                                                                                2

 

  1. Culture and sensitivity of the lesions
  2. Sulfamethoxazole-trimethoprim
  3. Topical antiseptic ointment

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 48: Contact Dermatitis Test Bank

Multiple Choice

 

 

  1. A child has irritant contact dermatitis with lesions on the extremities and face. Which treatment is recommended for this patient?

 

  1. Antihistamines
  2. Medium- to high-potency topical corticosteroids
  3. Oral corticosteroids
  4. Topical calcineurin inhibitors

 

 

 

  1. A patient who has been exposed to poison ivy presents with inflammation and a vesicular rash on one arm. The provider recommends a topical steroid, but the next day the patient calls to report similar lesions appearing on the face. What will the provider tell this patient?

 

  1. The rash is spreading through self-inoculation.
  2. The vesicles may continue to develop for up to 2
  3. The rash may spread over the next 8
  4. The patient must have been re-exposed to the

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 49: Corns and Calluses Test Bank

Multiple Choice

 

 

  1. A patient develops a corn on the dorsolateral aspect of the fifth toe on one foot. What will the practitioner do initially to treat this condition?

 

  1. Apply a 40% salicylic acid plaster over the lesion for 48 to 72 hours
  2. Gently pare the lesion with a No. 15 scalpel blade
  3. Obtain a foot radiograph to assess underlying bone structures
  4. Recommend trying an over-the-counter corn solution

 

 

 

  1. A patient with a soft corn develops an infection without surrounding erythema or edema. Which treatments are recommended?

Select all that apply.

 

  1. Oral erythromycin
  2. Salicylic acid patch
  3. Sanding with a pumice stone
  4. Topical mupirocin
  5. Twice-daily warm soaks

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 50: Cutaneous Herpes Test Bank

Multiple Choice

 

 

  1. A patient who has recurrent, frequent genital herpes outbreaks asks about therapy to minimize the episodes. What will the provider recommend as first-line treatment?

 

  1. Acyclovir
  2. Famciclovir
  3. Topical medications
  4. Valacyclovir

 

 

 

  1. A patient who has never had an outbreak of oral lesions reports a burning sensation on the oral mucosa and then develops multiple painful round vesicles at the site. A Tzanck culture confirms HSV-1 infection. What will the provider tell the patient about this condition?

 

  1. Antiviral medications are curative for oral
  2. The initial episode is usually the most
  3. There are no specific triggers for this type of
  4. Transmission to others occurs only when lesions are

 

 

 

  1. A patient who has had lesions for several days is diagnosed with primary herpes labialis and asks about using a topical medication. What will the provider tell this patient?

 

  1. Oral antivirals are necessary to treat this type of
  2. Preparations containing salicylic acid are most
  3. Topical medications can have an impact on pain and

 

Test Bank                                                                                                                                                2

 

  1. Topical medications will significantly shorten the healing

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 51: Dermatitis Medicamentosa Test Bank

Multiple Choice

 

 

  1. A patient is taking a sulfonamide antibiotic and develops a rash that begins peeling. Which type of rash is suspected?

 

  1. Erythema multiforme
  2. Stevens-Johnson
  3. Urticaria
  4. Wheal and flare

 

 

  1. A child is brought to a clinic with a sudden onset of rash after taking an antibiotic for 2 days. The provider notes all over wheals with pruritis, which the parent reports seem to come and go. Which action is correct?

 

  1. Admit the child to the hospital for treatment and observation
  2. Prescribe an oral antihistamine and follow up in 1 to 2 days
  3. Reassure the parent that the rash will eventually subside
  4. Suggest trying cool compresses and tepid baths at home

 

 

 

  1. Which types of medications are associated with urticarial type rashes? Select all that

 

  1. ACE inhibitors
  2. Erythromycin
  3. NSAIDs
  4. Penicillins
  5. Phenothiazines

 

Test Bank                                                                                                                                          2

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 52: Dry Skin Test Bank

Multiple Choice

 

 

  1. A patient who has chronically dry skin who has been using emollients and moisturizers reports an uneven diamond pattern and redness on the lower legs and arms. What will the provider recommend?

 

  1. A topical antibiotic ointment
  2. Increasing sodium consumption
  3. Referral to a dermatologist
  4. Using antihistamines at night

 

 

  1. When counseling a patient who has dry skin about ways to minimize exacerbations, what will the provider include?

Select all that apply.

 

  1. Cleanse the skin frequently
  2. Eat soups and stews frequently
  3. Take tepid-water baths
  4. Use topical corticosteroids regularly
  5. Use fragrance-free detergents

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 53: Eczematous Dermatitis (Atopic Dermatitis) Test Bank

Multiple Choice

 

 

  1. Which is the primary symptom causing discomfort in patients with atopic dermatitis?

 

  1. Dryness
  2. Erythema
  3. Lichenification
  4. Pruritis

 

 

  1. The parent of a 10-month-old child with atopic dermatitis asks what can be done to minimize the recurrence of symptoms in the child. What will the provider recommend?

 

  1. Calcineurin inhibitors
  2. Lubricants and emollients
  3. Oral diphenhydramine
  4. Prophylactic topical steroids

 

 

 

  1. A child who has atopic dermatitis has recurrent secondary bacterial skin infections. What will the provider recommend to help prevent these infections?

 

  1. Bleach baths twice weekly
  2. Frequent bathing with soap and water
  3. Low-dose oral antibiotics
  4. Topical antibiotic ointments

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 54: Fungal Infections (Superficial) Test Bank

Multiple Choice

 

 

  1. Which medication will the provider prescribe as first-line therapy to treat tinea capitis?

 

  1. Oral griseofulvin
  2. Oral ketoconazol
  3. Topical clotrimazole
  4. Topical tolnaftate

 

 

 

  1. When collecting a specimen to determine a diagnosis of tinea corporis, the provider will scrape which portion of the lesion?

 

  1. The active, leading border
  2. The area of central clearing
  3. The erythematous plaque
  4. The papular lesions

 

 

  1. When evaluating scalp lesions in a patient suspected of having tinea capitis, the provider uses a Wood’s lamp and is unable to elicit fluorescence. What is the significance of this finding?

 

  1. The patient does not have tinea
  2. The patient is less likely to have tinea
  3. The patient is positive for tinea
  4. The patient may have tinea

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 55: Herpes Zoster (Shingles) Test Bank

Multiple Choice

 

 

  1. A patient who has had a previous herpes zoster outbreak experiences a second outbreak and asks the provider about treatment to reduce the duration and severity of symptoms. What will the provider recommend?

 

  1. Acyclovir
  2. Lidocaine patch
  3. Oral corticosteroids
  4. Topical corticosteroids

 

 

 

  1. An older patient experiences a herpes zoster outbreak and asks the provider if she is contagious because she is going to be around her grandchild who is too young to be immunized for varicella. What will the provider tell her?

 

  1. An antiviral medication will prevent transmission to
  2. As long as her lesions are covered, there is no risk of
  3. Contagion is possible until all of her lesions are
  4. Varicella zoster and herpes zoster are different

 

 

  1. A patient has a unilateral vesicular eruption which is described as burning and stabbing in intensity. To differentiate between herpes simplex and herpes zoster, which test will the provider order?

 

Test Bank                                                                                                                                                2

 

  1. Polymerase chain reaction analysis
  2. Serum immunoglobulins
  3. Tzanck test
  4. Viral culture

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 56: Hidradenitis Suppurativa (Acne Inversa) Test Bank

Multiple Choice

 

 

  1. Which medications may be used as part of the treatment for a patient with hidradenitis suppurativa?

Select all that apply.

 

  1. Chemotherapy
  2. Erythromycin
  3. Infliximab
  4. Isotretinoin
  5. Prednisone

 

 

 

  1. A female patient is diagnosed with hidradenitis suppurativa and has multiple areas of swelling, pain, and erythema, along with several abscesses in the right femoral area. When counseling the patient about this disorder, the practitioner will include which information?

 

  1. Antibiotic therapy is effective in clearing up the
  2. It is often progressive with relapses and permanent
  3. The condition is precipitated by depilatories and
  4. The lesions are infective and the disease may be transmitted to

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 57: Hyperhidrosis Test Bank

Multiple Choice

 

 

  1. A patient is newly diagnosed with hyperhidrosis with excessive sweating on the palms and soles. What will the provider recommend to treat this condition?

 

  1. Aluminum chloride hexahydrate
  2. Liposuction of sweat glands
  3. Oral anticholinergic agents
  4. Thoracic endoscopic surgery

 

 

 

  1. A patient has excessive sweating of the palms, soles, and axillae. The provider understands that this presentation is often due to which cause?

 

  1. Anxiety
  2. Hormones
  3. Hypoglycemia
  4. Medications

 

 

 

  1. A patient reports generalized excessive sweating and states that night sweats are present. Which diagnostic test is a priority for this patient to determine the underlying cause?

 

  1. Blood pressure evaluation
  2. Fasting blood glucose
  3. Purified protein derivative test
  4. Thyroid function tests

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 58: Intertrigo Test Bank

Multiple Choice

 

 

  1. A patient with intertrigo shows no improvement and persistent redness after treatment with drying agents and antifungal medications. The patient reports an onset of odor associated with a low-grade fever. What will the provider do next to manage this condition?

 

  1. Culture the lesions to determine the cause
  2. Evaluate the patient for HIV infection
  3. Order topical nystatin cream
  4. Prescribe a cephalosporin antibiotic

 

 

 

  1. When recommending ongoing treatment for a patient who has recurrent intertrigo, what will the provider suggest?

Select all that apply.

 

  1. Aluminum sulfate solution
  2. Burow’s solution compresses
  3. Cornstarch application
  4. Nystatin cream
  5. Topical steroid cream

 

 

 

  1. An overweight patient has intertrigo, with recurrent fungal infections. In addition to medication therapy, what will the provider recommend to treat the condition?

 

Test Bank                                                                                                                                                2

 

Select all that apply.

 

  1. Apply moisturizer to affected areas
  2. Expose areas to light and air
  3. Use a hand-held dryer to dry the area
  4. Use powder containing cornstarch
  5. Wear natural-fiber clothing

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 59: Nail Disorders Test Bank

Multiple Choice

 

 

  1. A patient with recurrent herpetic whitlow is counseled about management of symptoms and prevention of complications. What will be included in this teaching?

Select all that apply.

 

  1. Begin antiviral medications within 3 days of onset of symptoms
  2. Contact the provider if symptoms persist longer than 3 weeks
  3. Cool compresses may help with comfort and decrease erythema
  4. Keep hands away from the mouth and eyes to prevent inoculation
  5. Wear gloves when preparing foods to prevent spread to others

 

 

 

  1. A patient is diagnosed with herpetic whitlow and in a follow-up evaluation, is noted to have paronychial inflammation of the tendon sheath in one finger. What is a priority treatment for this patient?

 

  1. Begin therapy with an oral antiviral medication
  2. Obtain a consult for incision and drainage of the lesion
  3. Order a creatinine clearance test to evaluate renal function
  4. Refer the patient to the emergency department

 

 

Test Bank                                                                                                                                                2

 

  1. A female patient who works with caustic chemicals has developed acute paronychia. What will he provider include when teaching this patient about her condition?

Select all that apply.

 

  1. Analgesics may be necessary for comfort
  2. Apply clear nail polish to protect her nails
  3. Avoid trimming the nails until the infection clears
  4. Use protective gloves while working
  5. Wear waterproof gloves when washing dishes

 

ANS: A, D, E

Patients with paronychia may require analgesics for comfort. They should be instructed to wear protective gloves while working, if the condition is work-related and to wear waterproof gloves while washing dishes. Nail polish should be avoided and nails should be kept trimmed and clean REF: Paronychia/Management/Education and Health Promotion

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 60: Pigmentation Changes (Vitiligo) Test Bank

Multiple Choice

 

 

  1. A patient with well-localized vitiligo is referred to a dermatologist for treatment. What will the initial treatment be?

 

  1. Chemical depigmentation with mequinol
  2. Narrow-band ultraviolet B light therapy
  3. Psoralens plus ultraviolet A light
  4. Twice-daily application of a mid-potency steroid cream

 

 

 

  1. A parent reports the appearance of areas of depigmented skin on a child which has spread rapidly. The provider notes asymmetrically patterned tri-colored, macules in a dermatomal distribution. What type of vitiligo does the provider suspect?

 

  1. Inflammatory vitiligo
  2. Segmented vitiligo
  3. Type A vitiligo
  4. Vitiligo with poliosis

 

 

  1. A patient who is diagnosed with vitiligo asks the provider what can be done to minimize the contrast between depigmented and normal skin. What will the provider recommend?

 

  1. Applying a cosmetic cover-up or tanning cream
  2. Lightening the dark skin areas with hydrogen peroxide
  3. Tanning for limited periods in a tanning booth

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 61: Pruritus Test Bank

Multiple Choice

 

 

  1. A patient has pruritis related to use of fabric softeners in clothing and reports all-over itching. A physical examination reveals no areas of inflammation. Besides stopping the use of this product, what is an initial intervention to stop the pruritis?

 

  1. Application of capsaicin
  2. Cooling the skin
  3. Topical antihistamines
  4. Topical corticosteroids

 

 

 

  1. A patient undergoing renal dialysis has extensive pruritis. Which medication will the provider order?

 

  1. Cholestyramine (Questran)
  2. Cyproheptadine (Periactin)
  3. Doxepin (Sinequan)
  4. Gabapentin (Neurontin)

 

 

 

  1. A patient complains of persistent pruritis of the extremities. A history is negative for medical and psychiatric causes and the patient has not had significant exposures. The physical examination of the affected skin is negative, except for marks made by scratching. What will the provider order to evaluate the cause of this itching?

Select all that apply.

 

Test Bank                                                                                                                                                2

 

  1. A skin biopsy specimen
  2. Blood urea nitrogen and serum creatinine
  3. Complete blood count with differential
  4. Referral for psychiatric evaluation
  5. Thyroid panel and blood glucose

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 62: Psoriasis Test Bank

Multiple Choice

 

 

  1. A child has plaques on the extensor surfaces of both elbows and on the face with minimal scaling and pruritis. What is the likely cause of these lesions?

 

  1. Atopic dermatitis
  2. Guttate psoriasis
  3. Psoriasis
  4. Seborrhea

 

 

 

  1. A patient with psoriasis develops lesions on the intertriginous areas of the skin. Which treatment is recommended?

 

  1. High-potency topical steroids
  2. Oral corticosteroid injections
  3. Topical steroids with vitamin D
  4. Topical, low-potency steroids

 

 

 

  1. A patient with severe, recalcitrant psoriasis has tried topical medications, intralesional steroid injections, and phototherapy with ultraviolet B light without consistent improvement in symptoms. What is the next step in treating this patient?

 

  1. Cyclosporine
  2. Etanercept

 

Test Bank                                                                                                                                                2

 

  1. Methotrexate
  2. Oral retinoids

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 63: Purpura Test Bank

Multiple Choice

 

 

  1. A patient has a purpural rash with flat, non-palpable lesions. Which laboratory tests will be most helpful in the initial diagnosis?

 

  1. Blood urea nitrogen and liver function studies
  2. Complete blood count with platelets
  3. Erythrocyte sedimentation rate or C-reactive protein
  4. Prothrombin time, partial thromboplastin time, and international normalized ratio

 

 

 

  1. A pediatric patient has immune thrombocytopenic purpura and has a platelet count of 60,000/mm3. What is the recommended treatment based on this laboratory value?

 

  1. Close observation
  2. High-dose steroids
  3. Intravenous immunoglobulin
  4. Possible splenectomy

 

 

 

  1. A patient presents with a purpural rash. The provider notes localized swelling and palpable lesion. What underlying condition may be the cause of this rash?

 

  1. A bleeding disorder
  2. A medication hypersensitivity
  3. A vasculitis disorder

 

Test Bank                                                                                                                                                2

  1. An infectious disease

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 64: Scabies Test Bank

Multiple Choice

 

 

  1. An adult patient has greasy, scaling patches on the forehead and eyebrows suggestive of seborrheic dermatitis. What is included in assessment and management of this condition? Select all that

 

  1. Begin first-line treatment with a topical antifungal medication
  2. Evaluate the scalp for dry, flaky scales and treat with selenium sulfide shampoo
  3. Teach the patient that proper treatment is curative in most instances
  4. Topical antibacterial medications may be used to prevent Malassezia proliferation
  5. Use topical steroids for several weeks to prevent recurrence of symptoms

 

 

 

  1. The provider is prescribing 5% permethrin cream for an adolescent patient who has scabies. What will the provider include in education for this patient?

 

  1. All household contacts will be treated only if
  2. Itching 2 weeks after treatment indicates treatment
  3. Stuffed animals and pillows should be placed in plastic bags for 1
  4. The adolescent’s school friends should be

 

 

  1. A patient has a pruritic eczematous dermatitis which has been present for one week and reports similar symptoms in other family members. What will the practitioner look for to help determine a diagnosis of scabies?

 

Test Bank                                                                                                                                                2

 

  1. Bullous lesions on the soles of the feet and palms of the hands
  2. Intra-epidermal burrows on the interdigital spaces of the hands
  3. Nits and small bugs along the scalp line at the back of the neck
  4. Pustular lesions in clusters on the trunk and extremities

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 65: Seborrheic Dermatitis Test Bank

Multiple Choice

 

 

  1. An adult patient has greasy, scaling patches on the forehead and eyebrows suggestive of seborrheic dermatitis. What is included in assessment and management of this condition? Select all that

 

  1. Begin first-line treatment with a topical antifungal medication
  2. Evaluate the scalp for dry, flaky scales and treat with selenium sulfide shampoo
  3. Teach the patient that proper treatment is curative in most instances
  4. Topical antibacterial medications may be used to prevent Malassezia proliferation
  5. Use topical steroids for several weeks to prevent recurrence of symptoms

 

 

 

  1. A patient with chronic seborrheic dermatitis reports having difficulty remembering to use the twice daily ketoconazole cream prescribed by the provider. What will the provider order for this patient?

 

  1. Burow’s solution soaks once daily
  2. Oral corticosteroids
  3. Oral itraconazole (Sporanox)
  4. Selenium sulfide shampoo 2.5% as a daily rinse

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 66: Stasis Dermatitis Test Bank

Multiple Choice

 

 

  1. Which treatment is most important in long-term management of stasis dermatitis?

 

  1. “Active” dressing application
  2. Compression therapy
  3. Massage therapy
  4. Systemic antibiotics

 

 

 

  1. A patient who has stasis dermatitis is instructed to apply an emollient to the skin around the ankles. What is the reason for this recommendation?

 

  1. To encourage formulation of granulation tissue
  2. To maintain optimum skin integrity
  3. To minimize the risk of allergic contact dermatitis
  4. To prevent itching and inflammation

 

 

 

  1. Which are elements of patient education when counseling a client who has stasis dermatitis about preventing complications associated with this disease?

Select all that apply.

 

  1. Applying emollients daily
  2. Keeping legs elevated when seated
  3. Minimizing exercise and ambulation
  4. Reducing fluid intake

 

Test Bank                                                                                                                                                2

  1. Weight reduction

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 67: Urticaria Test Bank

Multiple Choice

 

 

  1. A patient describes a wheal and flare type rash that recurs frequently with hives that appear and then fade within an hour. The provider notes that the patient demonstrates a wheal and flare reaction when the skin is stroked with a pen. What will the provider ask the patient to help determine the cause of this rash?

 

  1. If the patient takes any medications, such as NSAIDs regularly
  2. If there is a family history of thyroid autoimmunity disease
  3. Whether the patient is experiencing gastrointestinal discomfort
  4. Whether the patient is exposed to cold or water prior to the rash

 

 

 

  1. A patient with chronic urticaria is taking a high dose non-sedating H1 blocker medication but reports minimal relief from itching. What will the provider prescribe to help alleviate this symptom?

 

  1. A corticosteroid
  2. A leukotriene inhibitor
  3. A sedating antihistamine
  4. An H2 blocker

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 68: Warts Test Bank Multiple Choice

 

  1. A pregnant woman has a history of human papillomavirus (HPV) and asks what she should do to prevent spread of this disease to her newborn. What will the provider recommend?

 

  1. Administration of the HPV vaccine
  2. Elective caesarean section
  3. No precautions are necessary
  4. Referral for cryotherapy

 

 

 

  1. An adolescent patient has several warts on one hand. Which action by the provider is indicated?

 

  1. Evaluate the patient’s HPV immunization status
  2. Reassure the patient that these lesions will regress spontaneously
  3. Remind the patient not to touch the genitals to prevent self-inoculation
  4. Treat the patient with either chemical agents or cryotherapy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 69: Wound Management Test Bank

Multiple Choice

 

 

  1. A patient has a pressure ulcer that has been treated with topical medications. During a follow-up visit, the provider notes an area of red bumps in the lesion. What does this indicate?

 

  1. Healing tissue
  2. Poor perfusion
  3. Secondary infection
  4. Tunneling lesions

 

 

 

  1. A patient has an ulcer on one lower leg just above the medial malleolus. The provider notes irregular wound edges with granulation tissue and moderate exudate, with ankle edema in that leg. What is the initial treatment to help treat this wound?

 

  1. Compression therapy
  2. Hyperbaric oxygen therapy
  3. Revascularization procedures
  4. Skin grafting

 

 

 

  1. A patient with a wound containing necrotic tissue requires debridement. The practitioner notes an area of erythema and exudate in the wound. Which type of debridement will most likely be used?

 

Test Bank                                                                                                                                                2

 

  1. Autolytic debridement
  2. Biologic debridement
  3. Chemical debridement
  4. Mechanical debridement

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 70: Evaluation of the Eyes Test Bank

Multiple Choice

 

 

  1. During an eye examination, the provider notes a red light reflex in one eye but not the other. What is the significance of this finding?

 

  1. Normal physiologic variant
  2. Ocular disease requiring referral
  3. Potential infection in the “red” eye
  4. Potential vision loss in one eye

 

 

 

  1. A patient comes to clinic with diffuse erythema in one eye without pain or history of trauma. The examination reveals a deep red, confluent hemorrhage in the conjunctiva of that eye. What is the most likely treatment for this condition?

 

  1. Order lubricating drops or ointments
  2. Prescribe ophthalmic antibiotic drops
  3. Reassure the patient that this will resolve
  4. Refer to an ophthalmologist

 

 

 

  1. A provider performs an eye examination during a health maintenance visit and notes a difference of 0.5 mm in size between the patient’s pupils. What does this finding indicate?

 

  1. A relative afferent pupillary defect
  2. Indication of a difference in intraocular pressure
  3. Likely underlying neurological abnormality
  4. Probable benign, physiologic anisocoria

 

Test Bank                                                                                                                                                2

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 71: Cataracts

 

Test Bank

 

Multiple Choice

 

 

  1. A primary care provider may suspect cataract formation in a patient with which finding?

 

  1. Asymmetric red reflex b. Corneal opacification c. Excessive tearing
  2. Injection of conjunctiva

 

 

 

  1. Which are risk factors for development of cataracts? Select all that apply.

 

  1. Advancing age b. Cholesterol
  2. Conjunctivitis d. Smoking
  3. Ultraviolet light

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 72: Blepharitis, Hordeolum, and Chalazion

 

Test Bank

 

Multiple Choice

 

 

  1. A child has a localized nodule on one eyelid which is warm, tender, and erythematous. On examination, the provider notes clear conjunctivae and no discharge. What is the recommended treatment?

 

  1. Referral to an ophthalmologist b. Surgical incision and drainage c. Systemic antibiotics
  2. Warm compresses and massage of the lesion

 

 

  1. A patient has a gradually enlarging nodule on one upper eyelid and reports that the lesion is painful. On examination, the lesion appears warm and erythematous. The provider knows that this is likely to be which type of lesion?

 

  1. Blepharitis b. Chalazion c. Hordeolum d. Meibomian

 

 

 

  1. A patient reports has been using artificial tears for comfort because of burning and itching in both eyes, but reports worsening symptoms. The provider notes redness and discharge along the eyelid margins with clear conjunctivae. What is the recommended treatment?

 

  1. Antibiotic solution drops four times daily

 

 

 

 

Test Bank                                                                                                                                          2

 

 

  1. Compresses, lid scrubs, and antibiotic ointment
  2. Oral antibiotics given prophylactically for several months d. Reassurance that this is a self-limiting condition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 73: Conjunctivitis

 

Test Bank

 

Multiple Choice

 

 

  1. A patient who has a cold develops conjunctivitis. The provider notes erythema of one eye with profuse, watery discharge and enlarged anterior cervical lymph nodes, along with a fever. Which treatment is indicated?

 

  1. Antihistamine-vasoconstrictor drops b. Artificial tears and cool compresses c. Topical antibiotic eye drops
  2. Topical corticosteroid drops

 

 

 

  1. A patient reports bilateral reports burning and itching eyes for several days. The provider notes a boggy appearance to the conjunctivae, along with clear, watery discharge. The patient’s eyelids are thickened and discolored. There are no other symptoms. Which type of conjunctivitis is most likely?

 

  1. Allergic b. Bacterial c. Chemical d. Viral

 

 

 

 

 

 

Test Bank                                                                                                                                          2

 

 

  1. A patient with allergic conjunctivitis who has been using a topical antihistamine-vasoconstrictor medication reports worsening symptoms. What is the provider’s next step in managing this patient’s symptoms?

 

  1. Consider prescribing a topical mast cell stabilizer
  2. Determine the duration of treatment with this medication c. Prescribe a non-sedating oral antihistamine
  3. Refer the patient to an ophthalmologist for further care

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

 

Chapter 74: Corneal Surface Defects and Ocular Surface Foreign Bodies

 

Test Bank

 

Multiple Choice

 

 

  1. Which patients should be referred immediately to an ophthalmologist after eye injury and initial treatment?

Select all that apply.

 

  1. A patient who was sprayed by lawn chemicals b. A patient who works in a metal fabrication shop c. A patient with a corneal abrasion
  2. A patient with a full-thickness corneal laceration e. A patient with irritation secondary to wood dust

 

 

 

  1. A patient who works in a furniture manufacturing shop reports a sudden onset of severe eye pain while sanding a piece of wood and now has copious tearing, redness, and light sensitivity in the affected eye. On examination, the conjunctiva appears injected, but no foreign body is visualized. What is the practitioner’s next step?

 

  1. Administration of antibiotic eye drops b. Application of topical fluorescein dye c. Instillation of cyclopegic eye drops
  2. Irrigation of the eye with normal saline

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 75: Dry Eye Syndrome

Test Bank

 

Multiple Choice

 

  1. A patient has evaporative dry eye syndrome with eyelid inflammation. What are some
    pharmacologic and non-pharmacologic measures the provider can recommend?
    Select all that apply.

 

  1. Apply over-the-counter artificial tears as needed
  2. Avoid direct exposure to air conditioning
  3. Topical steroid eye drops as a maintenance medication
  4. Use non-tearing baby shampoo to gently scrub the eyelids
  5. Use tetrahydrozoline drops for discomfort

 

 

  1. A patient has chronically dry eyes, sometimes with a foreign body sensation, burning, and
    itching. A Schirmer test is abnormal. What is the suspected cause of this patient’s symptoms
    based on this test finding?

 

  1. Aqueous-deficiency
  2. Corneal abrasion
  3. Evaporative disorder
  4. Poor eyelid closure

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 76: Nasolacrimal Duct Obstruction and Dacryocystitis Test Bank

Multiple Choice

  1. A patient has dacryocystitis. The provider notes a painful lacrimal sac abscess that appears to be coming to a head. Which treatment will be useful initially?
  1. Eyelid scrubs with baby shampoo
  2. Incision and drainage
  3. Lacrimal bypass surgery
  4. Topical antibiotic ointment
  5. An adult patient with a history of recurrent sinusitis and allergic rhinitis reports chronic tearing in one eye, ocular discharge, and eyelid crusting. The provider suspects nasolacrimal duct obstruction. Which initial treatment will the provider recommend?
  6. Antibiotic eye drops
  7. Nasolacrimal duct probing
  8. Systemic antibiotics
  9. Warm compresses

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 77: Preseptal and Orbital Cellulitis Test Bank

Multiple Choice

 

 

  1. A patient has eyelid swelling with erythema and warmth and reports pain with eye movement. Which diagnostic tests will be performed to confirm a diagnosis of orbital cellulitis?

Select all that apply.

 

  1. Blood cultures
  2. Complete blood count
  3. CT scan of orbits
  4. Lumbar puncture
  5. Visual acuity testing

 

 

 

  1. Which is the most common cause of orbital cellulitis in all age groups?

 

  1. Bacteremic spread from remote infections
  2. Inoculation from local trauma or bug bites
  3. Local spread from the ethmoid sinus
  4. Paranasal sinus inoculation

 

 

  1. A child has unilateral eyelid edema, warmth and erythema and does not exhibit pain with ocular movement. Which is most likely true about this child’s infection?

 

  1. Decreased visual acuity may occur

 

Test Bank                                                                                                                                                2

 

  1. Increased intraocular pressure will be present
  2. Optic nerve compromise is a complication
  3. The eye is typically spared without conjunctivitis

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 78: Pinguecula and Pterygium Test Bank

Multiple Choice

 

 

  1. A patient has an elevated, yellowish-white lesion adjacent to the cornea at the 3 o’clock position of the right eye. The provider notes pinkish inflammation with dilated blood vessels surrounding the lesion. What will the provider tell the patient about this lesion?

 

  1. Artificial tear drops are contraindicated
  2. Spontaneous bleeding is likely
  3. UVB eye protection is especially important
  4. Visine may be used for symptomatic relief

 

 

 

  1. A patient who has an inflamed pterygia lesion has been using loteprednol topical steroid drops for 7 days. The patient shows no improvement in symptoms. What is the next course of action?

 

  1. Consult with an ophthalmologist
  2. Continue the medication for 7 more days
  3. Prescribe a systemic corticosteroid
  4. Refer the patient to the emergency department

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 79: Traumatic Ocular Disorders Test Bank

Multiple Choice

 

 

  1. A child sustains an ocular injury in which a shard of glass from a bottle penetrated into the eye wall. The emergency department provider notes that the shard has remained in the eye. Which best describes this type of injury?

 

  1. Intraocular foreign body
  2. Penetrating eye injury
  3. Perforating eye injury
  4. Ruptured globe injury

 

 

 

  1. A patient suffers a penetrating injury to one eye caused by scissors. The provider notes a single laceration away from the iris that involves the anterior but not the posterior segment. What is the prognosis for this injury?

 

  1. Because the posterior segment is not involved, the prognosis is good
  2. Blindness is likely with this type of eye injury
  3. Massive hemorrhage and loss of intraocular contents is likely
  4. Retinal detachment is almost certain to occur

 

 

  1. Which is an important protective precaution in a metal fabrication workshop?

 

  1. 2 mm polycarbonate safety glasses
  2. Eyewash stations
  3. Glasses with UVB protection

 

Test Bank                                                                                                                                                2

  1. Polycarbonate goggles

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 80: Auricular Disorders Test Bank

Multiple Choice

 

 

  1. During a routine physical examination, a provider notes a shiny, irregular, painless lesion on the top of one ear auricle and suspects skin cancer. What will the provider tell the patient about this lesion?

 

  1. A biopsy should be
  2. Immediate surgery is
  3. It is benign and will not need
  4. This is most likely

 

 

 

  1. A primary care provider notes painless, hard lesions on a patient’s external ears that expel a white crystalline substance when pressed. What diagnostic test is indicated?

 

  1. Biopsy of the lesions
  2. Endocrine studies
  3. Rheumatoid factor
  4. Uric acid chemical profile

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 81: Cerumen Impaction Test Bank

Multiple Choice

 

 

  1. A provider is recommending a cerumenolytic for a patient who has chronic cerumen buildup. The provider notes that the patient has dry skin in the ear canal. Which preparation is FDA approved for this use?

 

  1. Carbamide peroxide
  2. Hydrogen peroxide
  3. Liquid docusate sodium
  4. Mineral oil

 

 

 

  1. A patient complains of otalgia and difficulty hearing from one ear. The provider performs an otoscopic exam and notes a dark brown mass in the lower portion of the external canal blocking the patient’s tympanic membrane. What is the initial action?

 

  1. Ask the patient about previous problems with that ear
  2. Irrigate the canal with normal saline
  3. Prescribe a ceruminolytic agent for that ear
  4. Use a curette to attempt to dislodge the mass

 

 

  1. A child has recurrent impaction of cerumen in both ears and the parent asks what can be done to help prevent this. What will the provider recommend?

 

  1. Clean the outer ear and canal with a soft cloth

 

Test Bank                                                                                                                                                2

 

  1. Removing cerumen with a cotton-tipped swab
  2. Try thermal-auricular therapy when needed
  3. Use an oral irrigation tool to remove cerumen

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 82: Cholesteatoma Test Bank

Multiple Choice

 

 

  1. A child is diagnosed as having a congenital cholesteatoma. What is included in management of this condition?

Select all that apply.

 

  1. Antibacterial treatment
  2. Insertion of pressure equalizing tubes
  3. Irrigation of the ear canal
  4. Removal of debris from the ear canal
  5. Surgery to remove the lesion

 

 

 

  1. A young child has a pale, whitish discoloration behind the tympanic membrane ™. The provider notes no scarring on the TM and no retraction of the pars flaccida. The parent states that the child has never had an ear infection. What do these findings most likely represent?

 

  1. Chronic cholesteatoma
  2. Congenital cholesteatoma
  3. Primary acquired cholesteatoma
  4. Secondary acquired cholesteatoma

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 83: Impaired Hearing Test Bank

Multiple Choice

 

 

  1. Which are risk factors for developing hearing loss caused by presbycusis? Select all that

 

  1. Diabetes
  2. GERD
  3. High blood pressure
  4. Liver disease
  5. Smoking

 

 

 

  1. A child who has recurrent otitis media fails a hearing screen at school. The provider suspects which type of hearing loss in this child?

 

  1. Central
  2. Conductive
  3. Mixed type
  4. Sensorineural

 

 

 

  1. A screening audiogram on a patient is abnormal. Which test may the primary provider perform next to further evaluate the cause of this finding?

 

  1. Impedance audiometry
  2. Pure tone audiogram
  3. Speech reception test

 

Test Bank                                                                                                                                                2

  1. Tympanogram

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 84: Inner Ear Disturbances Test Bank

Multiple Choice

 

 

  1. A patient is suspected of having vestibular neuritis. Which finding on physical examination is consistent with this diagnosis?

 

  1. Facial palsy and vertigo
  2. Fluctuating hearing loss and tinnitus
  3. Spontaneous horizontal nystagmus
  4. Vertigo with changes in head position

 

 

 

  1. Which symptoms may occur with vestibular neuritis? Select all that

 

  1. Disequilibrium
  2. Fever
  3. Hearing loss
  4. Nausea and vomiting
  5. Tinnitus

 

 

 

  1. A patient reports several episodes of acute vertigo, some lasting up to an hour, associated with nausea and vomiting. What is part of the initial diagnostic workup for this patient?

 

  1. Audiogram and MRI
  2. Auditory brainstem testing
  3. Electrocochleography

 

Test Bank                                                                                                                                                2

  1. Vestibular testing

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 85: Otitis Externa Test Bank

Multiple Choice

 

 

  1. A patient reports a feeling of fullness and pain in both ears and the practitioner elicits exquisite pain when manipulating the external ear structures. What is the likely diagnosis?

 

  1. Acute otitis externa
  2. Acute otitis media
  3. Chronic otitis externa
  4. Otitis media with effusion

 

 

 

  1. Which are risk factors for developing otitis externa? Select all that

 

  1. Cooler, low-humidity environments
  2. Exposure to someone with otitis externa
  3. Having underlying diabetes mellitus
  4. Use of ear plugs and hearing aids
  5. Vigorous external canal hygiene

 

 

 

  1. A patient has an initial episode otitis external associated with swimming. The patient’s ear canal is mildly inflamed and the tympanic membrane is not involved. Which medication will be ordered?

 

  1. Cipro HC

 

Test Bank                                                                                                                                                2

 

  1. Fluconazole
  2. Neomycin
  3. Vinegar and alcohol

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 86: Otitis Media Test Bank

Multiple Choice

 

 

  1. Which symptoms in children are evaluated using a parent-reported scoring system to determine the severity of pain in children with otitis media?

Select all that apply.

 

  1. Appetite
  2. Difficulty sleeping
  3. Level of cooperation
  4. Poor hearing
  5. Tugging on ears

 

 

 

  1. Which patient may be given symptomatic treatment with 24 hours follow-up assessment without initial antibiotic therapy?

 

  1. A 36 month old with fever of 38.5° C, mild otalgia, and red, non-bulging TM
  2. A 4 year old, afebrile child with bilateral otorrhea
  3. A 5 year old with fever of 38.0° C, severe otalgia, and red, bulging TM
  4. A 6 month old with fever of 39.2° C, poor sleep and appetite and bulging TM

 

 

 

  1. A pediatric patient has otalgia, fever of 38.8° C, and a recent history of upper respiratory examination. The examiner is unable to visualize the tympanic membranes in the right ear because of the presence of cerumen in the ear canal. The left tympanic membrane is dull gray with fluid levels present. What is the correct action?

 

Test Bank                                                                                                                                                2

 

  1. Perform a tympanogram on the right ear
  2. Recommend symptomatic treatment for fever and pain
  3. Remove the cerumen and visualize the tympanic membrane
  4. Treat empirically with amoxicillin 80 to 90 mg/kg/day

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 87: Tympanic Membrane Perforation Test Bank

Multiple Choice

 

 

  1. A patient reports ear pain and difficulty hearing. An otoscopic examination reveals a small tear in the tympanic membrane of the affected ear with purulent discharge. What is the initial treatment for this patient?

 

  1. Insert a wick into the ear canal
  2. Irrigate the ear canal to remove the discharge
  3. Prescribe antibiotic ear drops
  4. Refer the patient to an otolaryngologist

 

 

 

  1. A patient reports ear pain after being hit in the head with a baseball. The provider notes a perforated tympanic membrane. What is the recommended treatment?

 

  1. Order antibiotic ear drops if signs of infection occur
  2. Prescribe analgesics and follow up in 1 to 2 days
  3. Reassure the patient that this will heal without problems
  4. Refer the patient to an otolaryngologist for evaluation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 88: Chronic Nasal Congestion and Discharge Test Bank

Multiple Choice

 

 

  1. A patient reports persistent nasal blockage, nasal discharge, and facial pain lasting on the right side for the past 4 months. There is no history of sneezing or eye involvement. The patient has a history of seasonal allergies and takes a non-sedating antihistamine. What does the provider suspect is the cause of these symptoms?

 

  1. Allergic rhinitis
  2. Autoimmune vasculitides
  3. Chronic rhinosinusitis
  4. Rhinitis medicamentosa

 

 

 

  1. A provider determines that a patient has chronic rhinosinusitis without nasal polyps. What is the first-line treatment for this condition?

 

  1. Intranasal corticosteroids
  2. Oral decongestants
  3. Systemic corticosteroids
  4. Topical decongestants

 

 

 

  1. A pregnant woman develops nasal congestion with chronic nasal discharge. What is the recommended treatment for this patient?

 

  1. Intranasal corticosteroids

 

Test Bank                                                                                                                                                2

 

  1. Prophylactic antibiotics
  2. Saline lavage
  3. Topical decongestants

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 89: Epistaxis Test Bank

Multiple Choice

 

 

  1. A patient has recurrent epistaxis without localized signs of irritation. Which laboratory tests may be performed to evaluate this condition?

Select all that apply.

 

  1. BUN and creatinine
  2. CBC with platelets
  3. Liver function tests
  4. PT and PTT
  5. PT/INR

 

 

 

  1. A patient is in the emergency department with unilateral epistaxis that continues to bleed after 15 minutes of pressure on the anterior septum and application of a topical nasal decongestant. The provider is unable to visualize the site of the bleeding. What is the next measure for this patient?

 

  1. Chemical cautery
  2. Electrocautery
  3. Nasal packing
  4. Petrolatum ointment

 

 

 

  1. A patient has bilateral bleeding from the nose with bleeding into the pharynx. What is the initial intervention for this patient?

 

  1. Apply firm, continuous pressure to the nostrils
  2. Assess airway safety and vital signs
  3. Clear the blood with suction to identify site of bleeding

 

Test Bank                                                                                                                                                2

  1. Have the patient sit up straight and tilt the head forward

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 90: Nasal Trauma Test Bank

Multiple Choice

 

 

  1. A provider performs a nasal speculum examination on a patient who sustained nasal trauma in a motor vehicle accident. The provider notes marked swelling of the nose, instability and crepitus of the nasal septum with no other facial bony abnormalities and observes a rounded bluish mass against the nasal septum. Which action is necessary at this time?

 

  1. CT scan of facial structures
  2. Ice packs to reduce facial swelling
  3. Surgery to reduce the nasal fracture
  4. Urgent drainage of the mass

 

 

 

  1. An alert, irritable 12-month-old child is brought to the emergency department by a parent who reports that the child fell into a coffee table. The child has epistaxis, periorbital ecchymosis, and nasal edema. Nares are patent and the examiner palpates instability and point tenderness of the nasal septum. The orbital structures appear intact. What is an urgent action for this patient?

 

  1. Assessment of tetanus vaccination
  2. Ice, head elevation, and analgesia
  3. Immediate nasal reduction surgery
  4. Involvement of social services

 

 

Test Bank                                                                                                                                                2

 

 

  1. A child is hit with a baseball bat during a game and sustains an injury to the nose, along with a transient loss of consciousness. A health care provider at the game notes bleeding from the child’s nose and displacement of the septum. What is the most important intervention at this time?

 

  1. Apply ice to the injured site to prevent airway occlusion
  2. Immobilize the child’s head and neck and call 911
  3. Place nasal packing in both nares to stop the bleeding
  4. Turn the child’s head to the side to prevent aspiration of blood

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 91: Rhinitis Test Bank

Multiple Choice

 

 

  1. A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and thin, clear nasal secretions. The provider notes puffiness around the eyes. The patient’s vital signs are normal. What is the most likely diagnosis for this patient?

 

  1. Acute sinusitis
  2. Allergic rhinitis
  3. Chronic sinusitis
  4. Viral rhinitis

 

 

 

  1. A patient has seasonal rhinitis symptoms and allergy testing reveals sensitivity to various trees and grasses. What is the first-line treatment for this patient?

 

  1. Antihistamine spray
  2. Intranasal cromolyn
  3. Intranasal steroids
  4. Oral antihistamines

 

 

 

  1. A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting out of bed in the morning. The patient denies itching and sneezing. A physical examination reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend for this patient?

 

  1. Consultation for immunotherapy

 

Test Bank                                                                                                                                                2

 

  1. Daily intranasal steroids
  2. Oral antihistamines each morning
  3. Oral decongestants as needed

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 92: Sinusitis Test Bank

Multiple Choice

 

 

  1. A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting out of bed in the morning. The patient denies itching and sneezing. A physical examination reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend for this patient?

 

  1. Consultation for immunotherapy
  2. Daily intranasal steroids
  3. Oral antihistamines each morning
  4. Oral decongestants as needed

 

 

 

  1. Which are potential complications of chronic or recurrent sinusitis? Select all that

 

  1. Allergic rhinitis
  2. Asthma
  3. Meningitis
  4. Orbital infection
  5. Osteomyelitis

 

 

 

  1. A patient has nasal congestion, fever, purulent nasal discharge, headache, and facial pain and begins treatment with amoxicillin-clavulanate. At a follow-up visit 10 days after initiation of treatment, the patient continues to have purulent discharge, congestion, and facial pain without fever. What is the next course of action for this patient?

 

Test Bank                                                                                                                                                2

 

 

  1. A CT scan of the paranasal sinuses
  2. A referral to an otolaryngologist
  3. A second course of amoxicillin-clavulanate
  4. A trial of azithromycin

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 93: Smell and Taste Disturbances Test Bank

Multiple Choice

 

 

  1. An elderly patient has a permanent loss of the sense of smell and diminished taste. What will be included in teaching this patient about managing these symptoms?

Select all that apply.

 

  1. Avoiding perfumes and perfumed soaps
  2. Eating regular meals at scheduled times
  3. Putting dates on food in the refrigerator
  4. The importance of installing smoke detectors
  5. Using gas rather than electrical appliances

 

 

 

  1. A patient reports that meat smells different than it used to. What word describes this dysfunction?

 

  1. Aliageusia
  2. Anosmia
  3. Dysgeusia
  4. Parosmia

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 94: Tumors and Polyps of the Nose Test Bank

Multiple Choice

 

 

  1. A provider examines a patient who has chronic nasal obstruction, respiratory tract symptoms, and generalized malaise. An examination of the nasal mucosa reveals ulceration of the nasal septum. What is the most important action when caring for this patient?

 

  1. Administering prednisone
  2. Obtaining a chest radiograph
  3. Performing laboratory tests
  4. Referring to a specialist

 

 

 

  1. A patient reports chronic nasal obstruction and difficulty distinguishing smells. The provider examines the nares with a nasal speculum and observes several grapelike lesions in both nostrils. What is the likely cause of this patient’s symptoms?

 

  1. Chronic sinusitis
  2. Nasal polyps
  3. Squamous cell carcinoma
  4. Vascular benign tumor

 

 

 

 

  1. A patient reports chronic nasal obstruction and recurrent epistaxis. Which type of nasal mass is likely?

 

  1. Inverted papilloma
  2. Nasal polyp
  3. Paranasal lymphoma

 

Test Bank                                                                                                                                                2

  1. Squamous cell carcinoma

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 95: Dental Abscess Test Bank

Multiple Choice

 

 

  1. A patient has been taking amoxicillin for treatment of a dental abscess. In a follow-up visit, the provider notes edema of the eyelids and conjunctivae. What is the next action?

 

  1. Hospitalize the patient for an endodontist consultation
  2. Prescribe amoxicillin clavulanate for 10 to 14 days
  3. Recommend follow up with a dentist in 2 to 3 days
  4. Suggest using warm compresses to the eyes for comfort

 

 

 

  1. A patient reports tooth pain in a lower molar and the provider notes a mobile tooth with erythema and edema of the surrounding tissues without discharge. Which is the initial course of action by the provider?

 

  1. Perform an incision and drainage of the edematous tissue
  2. Prescribe amoxicillin and refer to a dentist in 2 to 3 days
  3. Recommend oral antiseptic rinses and follow up in one week
  4. Refer to an oral surgeon for emergency surgery

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 96: Diseases of the Salivary Glands Test Bank

Multiple Choice

 

 

  1. A patient has a chronic swelling of the parotid gland that is unresponsive to antibiotics and which has not increased in size. Which diagnostic test is indicated?

 

  1. Computed tomography
  2. Fine needle aspiration
  3. Magnetic resonance imaging
  4. Plain film radiography

 

 

 

  1. A patient reports painful swelling in the mouth with increased pain at mealtimes. The provider notes a mass in the salivary gland region. What is the likely cause of these symptoms?

 

  1. Basal cell adenoma
  2. Sialolithiasis
  3. Sjogren syndrome
  4. Warthin’s tumor

 

 

  1. A patient has parotitis and cultures are positive for actinomycosis. What is the initial treatment for this condition?

 

  1. Intravenous penicillin
  2. Oral clindamycin
  3. Oral erythromycin

 

Test Bank                                                                                                                                                2

  1. Topical antibiotics

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 97: Epiglottitis Test Bank

Multiple Choice

 

 

  1. An adult patient has epiglottitis secondary to a chemical burn. Which medication will be given initially to prevent complications?

 

  1. Chloramphenicol
  2. Clindamycin
  3. Dexamethasone
  4. Metronidazole

 

 

 

  1. An adult patient is seen in clinic with fever, sore throat, and dysphagia. Which diagnostic test will the provider order to confirm a diagnosis of epiglottitis?

 

  1. Blood cultures
  2. Complete blood count
  3. Fiberoptic nasopharyngoscopy
  4. Lateral neck film

 

 

 

  1. The provider sees a child with a history of high fever and sore throat. When entering the exam room, the provider finds the child sitting in the tripod position and notes stridor, drooling, and anxiety. What is the initial action for this patient?

 

  1. Administer empiric intravenous antibiotics and steroids
  2. Have the child lie down and administer high-flow, humidified oxygen
  3. Obtain an immediate consultation with an otolaryngologist
  4. Perform a thorough examination of the oropharynx

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 98: Oral Infections Test Bank

Multiple Choice

 

 

  1. A patient reports painful oral lesions 3 days after feeling pain and tingling in the mouth. The provider notes vesicles and ulcerative lesions on the buccal mucosa. What is the most likely cause of these symptoms?

 

  1. Bacterial infection
  2. Candida albicans
  3. Herpes simplex virus
  4. Human papilloma virus

 

 

 

  1. A patient has gingival inflammation with several areas of ulceration and a small amount of purulent discharge. What is required to diagnose this condition?

 

  1. Culture and sensitivity
  2. Microscopic exam of oral scrapings
  3. Physical examination
  4. Tzanck smear

 

 

 

  1. A patient has painful oral lesions and the provider notes several white, verrucous lesions in clusters throughout the mouth. What is the recommended treatment for this patient?

 

  1. Nystatin oral suspension

 

Test Bank                                                                                                                                                2

 

  1. Oral acyclovir
  2. Oral hygiene measures
  3. Surgical excision

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 99: Parotitis Test Bank

Multiple Choice

 

 

  1. Which physical examination finding suggests viral rather than bacterial parotitis?

 

  1. Clear discharge from Stensen’s duct
  2. Enlargement and pain of affected glands
  3. Gradual reduction in saliva production
  4. Unilateral edema of parotid glands

 

 

 

  1. A patient who has acute suppurative parotitis has been taking amoxicillin-clavulanate for 4 days without improvement in symptoms. The provider will order an antibiotic for Methicillin-resistant S. aureus. Which other measure may be helpful?

 

  1. Cool compresses
  2. Discouraging chewing gum
  3. Surgical drainage
  4. Topical corticosteroids

 

 

 

  1. What are factors associated with acute suppurative parotitis? Select all that

 

  1. Allergies
  2. Anticholinergic medications
  3. Diabetes mellitus
  4. Hypervolemia

 

Test Bank                                                                                                                                                2

  1. Radiotherapy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 100: Peritonsillar Abscess Test Bank

Multiple Choice

 

 

  1. An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes foul- smelling breath and a muffled voice with marked edema and erythema of the peritonsillar tissue. What will the primary care provider do?

 

  1. Evaluate for possible epiglottitis
  2. Perform a rapid strep and throat culture
  3. Prescribe empiric oral antibiotics
  4. Refer the patient to an otolaryngologist

 

 

  1. A patient is diagnoses with peritonsillar abscess and will be hospitalized for intravenous antibiotics. What additional treatment will be required?

 

  1. Intubation to protect the airway
  2. Needle aspiration of the abscess
  3. Systemic corticosteroid administration
  4. Tonsillectomy and adenoidectomy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 101: Pharyngitis and Tonsillitis Test Bank

Multiple Choice

 

 

  1. A patient has sore throat, a temperature of 38.5° C, tonsillar exudates, and cervical lymphadenopathy. What will the provider do next to manage this patient’s symptoms?

 

  1. Order an antistreptolysin O titer
  2. Perform a rapid antigen detection test
  3. Prescribe empiric penicillin
  4. Refer to an otolaryngologist

 

 

 

  1. A patient reports a sudden onset of sore throat, fever, malaise, and cough. The provider notes mild erythema of the pharynx and clear rhinorrhea without cervical lymphadenopathy. What is the most likely cause of these symptoms?

 

  1. Allergic pharyngitis
  2. Group A streptococcus
  3. Infectious mononucleosis
  4. Viral pharyngitis

 

 

 

  1. A school-age child has had 5 episodes of tonsillitis in the past year and 2 episodes the previous year. The child’s parent asks the provider if the child needs a tonsillectomy. What will the provider tell this parent?

 

  1. Current recommendations do not support tonsillectomy for this
  2. If there is one more episode in the next 6 months, a tonsillectomy is

 

Test Bank                                                                                                                                                2

 

  1. The child should have radiographic studies to evaluate the need for
  2. Tonsillectomy is recommended based on this child’s

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 102: Acute Bronchitis Test Bank

Multiple Choice

 

 

  1. An adult patient who had pertussis immunizations as a child is exposed to pertussis and develops a runny nose, low-grade fever, and upper respiratory illness symptoms without a paroxysmal cough. What is recommended for this patient?

 

  1. Azithromycin daily for 5 days
  2. Isolation if paroxysmal cough develops
  3. Pertussis vaccine booster
  4. Symptomatic care only

 

 

 

  1. A patient develops a dry, non-productive cough and is diagnosed with bronchitis. Several days later, the cough becomes productive with mucoid sputum. What may be prescribed to help with symptoms?

 

  1. Antibiotic therapy
  2. Antitussive medication
  3. Bronchodilator treatment
  4. Mucokinetic agents

 

 

  1. A patient develops acute bronchitis and is diagnosed as having influenza. Which medication will help reduce the duration of symptoms in this patient?

 

Test Bank                                                                                                                                                2

 

 

  1. Azithromycin
  2. Clindamycin
  3. Oseltamivir
  4. Trimethoprim-sulfamethoxazole

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 103: Asthma Test Bank

Multiple Choice

 

 

  1. A patient who has asthma calls the provider to report having a peak flow measure of 75%, shortness of breath, wheezing, and cough, and tells the provider that the symptoms have not improved significantly after a dose of albuterol. The patient uses an inhaled corticosteroid medication twice daily. What will the provider recommend?

 

  1. Administering two more doses of albuterol
  2. Coming to the clinic for evaluation
  3. Going to the emergency department
  4. Taking an oral corticosteroid

 

 

 

  1. An adult develops chronic cough with episodes of wheezing and shortness of breath. The provider performs chest radiography and other tests and rules out infection, upper respiratory, and gastroesophageal causes. Which test will the provider order initially to evaluate the possibility of asthma as the cause of these symptoms?

 

  1. Allergy testing
  2. Methacholine challenge test
  3. Peak expiratory flow rate
  4. Spirometry

 

 

Test Bank                                                                                                                                                2

 

  1. A patient is seen in clinic for an asthma exacerbation. The provider administers three nebulizer treatments with little improvement, noting a pulse oximetry reading of 90% with 2 L of oxygen. A peak flow assessment is 70%. What is the next step in treating this patient?

 

  1. Administer three more nebulizer treatments and reassess
  2. Admit to the hospital with specialist consultation
  3. Give epinephrine injections and monitor response
  4. Prescribe an oral corticosteroid medication

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 104: Chest Pain (Noncardiac) Test Bank

Multiple Choice

 

 

  1. A patient comes to an emergency department with chest pain. The patient describes the pain is sharp and stabbing and reports that it has been present for several weeks. Upon questioning, the examiner determines that the pain is worse after eating. The patient reports getting relief after taking a friend’s nitroglycerin during one episode. What is the most likely cause of this chest pain?

 

  1. Aortic dissection pain
  2. Cardiac pain
  3. Esophageal pain
  4. Pleural pain

 

 

 

  1. A patient has chronic chest pain that occurs after meals and the provider suspects gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor and after 2 months the patient reports improvement in symptoms. What is the next action in treating this patient?

 

  1. Continue the proton pump inhibitor
  2. Order esophageal pH monitoring
  3. Refer the patient to a gastroenterologist
  4. Schedule an upper endoscopy

 

 

 

  1. A high school athlete reports recent onset of chest pain that is aggravated by deep breathing and lifting. A 12-lead electrocardiogram in the clinic is normal. The examiner notes localized pain near the sternum that increases with pressure. What will the provider do next?

 

Test Bank                                                                                                                                                2

 

 

  1. Order a chest radiograph
  2. Prescribe an antibiotic
  3. Recommend an NSAID
  4. Refer to a cardiologist

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 105: Chronic Cough Test Bank

Multiple Choice

 

 

  1. A young adult patient develops a cough persisting longer than 2 months. The provider orders pulmonary function tests and a chest radiograph, which are normal. The patient denies abdominal complaints. There are no signs of rhinitis or sinusitis and the patient does not take any medications. What will the provider evaluate next to help determine the cause of this cough?

 

  1. 24-hour esophageal pH monitoring
  2. Methacholine challenge test
  3. Sputum culture
  4. Tuberculosis testing

 

 

 

  1. A patient is recovering from Mycoplasma pneumoniae infection and has a persistent cough 6 weeks after the infection. What will the provider do?

 

  1. Perform chest radiography to assess for secondary infection
  2. Perform pulmonary function and asthma challenge testing
  3. Prescribe a second round of azithromycin to treat the persistent infection
  4. Reassure the patient that this is common after M. pneumoniae infection

 

 

Test Bank                                                                                                                                                2

 

  1. A non-smoking adult with a history of cardiovascular disease reports having a chronic cough without fever or upper airway symptoms. A chest radiograph is normal. What will the provider consider initially as the cause of this patient’s cough?

 

  1. ACE inhibitor medication use
  2. Chronic obstructive pulmonary disease
  3. Gastroesophageal reflux disease
  4. Psychogenic cough

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 106: Chronic Obstructive Pulmonary Disease Test Bank

Multiple Choice

 

 

  1. Which is characteristic of chronic bronchitis and not emphysema?

 

  1. Damage to the alveolar wall
  2. Destruction of alveolar architecture
  3. Mild alteration in lung tissue compliance
  4. Mismatch of ventilation and perfusion

 

 

  1. A patient with chronic obstructive pulmonary disease and reports daily symptoms of dyspnea and cough. Which medication will the prescriber order?

 

  1. Ipratropium bromide
  2. Pirbuterol acetate
  3. Salmeterol xinafoate
  4. Theophylline

 

 

 

  1. Which test is most diagnostic for chronic obstructive pulmonary disease?

 

  1. COPD Assessment Test
  2. Forced expiratory time maneuver
  3. Lung radiograph
  4. Spirometry for FVC and FEV1

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 107: Dyspnea Test Bank

Multiple Choice

 

 

  1. A young adult patient without a previous history of lung disease has an increased respiratory rate and reports a feeling of “not getting enough air.” The provider auscultates clear breath sounds and notes no signs of increased respiratory effort. Which diagnostic test will the provider perform initially?

 

  1. Chest radiograph
  2. Complete blood count
  3. Computerized tomography
  4. Spirometry

 

 

 

  1. A patient reports shortness of breath with activity and exhibits increased work of breathing with prolonged expirations. Which diagnostic test will the provider order to confirm a diagnosis in this patient?

 

  1. Arterial blood gases
  2. Blood cultures
  3. Spirometry
  4. Ventilation/perfusion scan

 

 

Test Bank                                                                                                                                                2

 

  1. An older patient with COPD is experiencing dyspnea and has an oxygen saturation of 89% on room air. The patient has no history of pulmonary hypertension or congestive heart failure. What will the provider order to help manage this patient’s dyspnea?

 

  1. Anxiolytic drugs
  2. Breathing exercises
  3. Opioid medications
  4. Supplemental oxygen

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 108: Hemoptysis Test Bank

Multiple Choice

 

 

  1. A patient with hemoptysis and no other symptoms has a normal chest radiograph, CT, and fiberoptic bronchoscopy studies. What is the next action in managing this patient?

 

  1. Observation
  2. Prophylactic antibiotics
  3. Specialist consultation
  4. Surgical intervention

 

 

 

  1. A patient reports coughing up a small amount of blood after a week of cough and fever. The patient has been previously healthy and does not smoke or work around pollutants or irritants. What will the provider suspect as the most likely cause of this patient’s symptoms?

 

  1. Infection
  2. Lung abscess
  3. Malignancy
  4. Thromboembolism

 

 

  1. A patient with a smoking history of 35 pack years reports having a chronic cough with recent symptoms of pink, frothy blood on a tissue. The chest radiograph shows a possible nodule in the right upper lobe. Which diagnostic test is indicated?

 

  1. Coagulation studies
  2. Computerized tomography
  3. Fiberoptic bronchoscopy
  4. Needle biopsy

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 109: Lung Cancer Test Bank

Multiple Choice

 

 

  1. A patient with small cell lung cancer (SCLC) has undergone chemotherapy with a good initial response to therapy. What will the provider tell this patient about the prognosis for treating this disease?

 

  1. Surgical resection will improve survival
  2. That relapse is likely with a poor
  3. There is an 80% chance of 5-year
  4. Treatment will proceed with curative

 

 

 

  1. When screening for metastatic cancer in a patient with lung cancer, the provider will assess for

Select all that apply.

 

  1. complaints of
  2. increased
  3. low hematocrit.
  4. lymph nodes greater than 1
  5. unexplained weight

 

 

  1. A patient with a cough has a suspicious lung lesion, a mediastinal lymph mass, and several bone lesions. What test is indicated to determine histology and staging of this cancer?

 

  1. Biopsy of a bone lesion

 

Test Bank                                                                                                                                                2

 

  1. Bone marrow aspiration and biopsy
  2. Bronchoscopy with lung biopsy
  3. Thoracentesis and pleural fluid cytology

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 110: Pleural Effusions and Pleurisy Test Bank

Multiple Choice

 

 

  1. Which are causes of pleural effusions? Select all that

 

  1. Allergies
  2. Breast cancer
  3. Bronchiectasis
  4. Congestive heart failure
  5. Dehydration

 

 

 

  1. A patient complains of shortness of breath when in a recumbent position and reports coughing and pain associated with inspiration. The provider notes distended neck veins during the exam. What is the likely cause of these findings?

 

  1. Congestive heart failure
  2. Hepatic disease
  3. Pulmonary embolus
  4. Pulmonary infection

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 111: Pneumonia Test Bank

Multiple Choice

 

 

  1. A patient has a cough and fever and the provider auscultates rales in both lungs that do not clear with cough. The patient reports having a headache and sore throat prior to the onset of coughing. A chest radiograph shows patchy, nonhomogeneous infiltrates. Based on these findings, which organism is the most likely cause of this patient’s pneumonia?

 

  1. A virus
  2. Mycoplasma
  3. pneumoniae
  4. Tuberculosis

 

 

 

  1. A young adult, previously healthy clinic patient has symptoms of pneumonia including high fever and cough. Auscultation reveals rales in the left lower lobe. A chest radiograph is normal. The patient is unable to expectorate sputum. Which treatment is recommended for this patient?

 

  1. A B-lactam antibiotic plus a fluoroquinolone
  2. A respiratory fluoroquinolone antibiotic
  3. Empiric treatment with a macrolide antibiotic
  4. Hospitalization for intravenous antibiotics

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 112: Pneumothorax Test Bank

Multiple Choice

 

 

  1. A patient who has a central line develops respiratory compromise. What is the initial intervention for this patient?

 

  1. Lung ultrasonography to determine the cause
  2. Obtaining cultures and starting antibiotics
  3. Prompt removal of the central line
  4. Rapid assessment and resuscitation

 

 

 

  1. Which method of treatment is used for traumatic pneumothorax?

 

  1. Needle aspiration of the pneumothorax
  2. Observation for spontaneous resolution
  3. Placement of a small-bore catheter
  4. Tube thoracostomy

 

 

 

 

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 113: Pulmonary Embolism Test Bank

Multiple Choice

 

 

  1. Which clinical sign is especially worrisome in a patient with a pulmonary embolism?

 

  1. Abnormal lung sounds
  2. Dyspnea
  3. Hypotension
  4. Tachycardia

 

 

 

  1. A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism?

 

  1. Arterial blood gases
  2. CT angiography
  3. D-dimer
  4. Electrocardiogram

 

 

 

  1. A patient develops a pulmonary embolism after surgery and shows signs of right-sided heart failure. Which drug will be administered to this patient?

 

  1. Low molecular heparin
  2. Tissue plasminogen activator
  3. Unfractionated heparin
  4. Warfarin

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 114: Pulmonary Hypertension Test Bank

Multiple Choice

 

 

  1. A patient with increased left-sided heart pressure will have which type of pulmonary hypertension?

 

  1. Group 2
  2. Group 3
  3. Group 4
  4. Group 5

 

 

 

  1. A patient who has had mild pulmonary hypertension with a previous symptom of a loud second heart sound on exam now has edema and jugular vein distension. This indicates which complication?

 

  1. Left ventricular dysfunction
  2. Right ventricular dysfunction
  3. Tricuspid valve involvement
  4. Mitral valve involvement

 

 

 

  1. A patient with pulmonary arterial hypertension (PAH) has increased dyspnea with activity. Which drug may be prescribed to manage this on an outpatient basis?

 

  1. An inhaled prostanoid
  2. Bosentan
  3. Epoprostenol
  4. Trepostinil

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 115: Sarcoidosis Test Bank

Multiple Choice

 

 

  1. A patient who has dyspnea and chest pain along with occasional chills and night sweats has a chest radiograph that shows bilateral hilar lymphadenopathy and pulmonary infiltrates. The provider suspects which classification of sarcoidosis?

 

  1. Stage 1
  2. Stage 2
  3. Stage 3
  4. Stage 4

 

 

 

  1. A patient with stage 1 sarcoidosis who is taking a nonsteroidal anti-inflammatory medication to treat joint discomfort develops mild dyspnea and cough. Which medication will be added to treat this symptom?

 

  1. A beta-adrenergic medication
  2. An antimalarial agent
  3. An immunosuppressant drug
  4. An oral corticosteroid

 

 

 

  1. When following a patient with sarcoidosis over time, which diagnostic test is useful to help monitor the progression of the disease?

 

  1. Chest radiographs
  2. Erythrocyte sedimentation rate
  3. Pulmonary function test
  4. Radionucleotide scanning

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 116: Cardiac Diagnostic Testing: Noninvasive Assessment of Coronary Artery Disease

 

Test Bank Multiple Choice

 

  1. An asymptomatic 63-year-old female has a low-density lipoprotein level of 135 mg/dL. Which test is beneficial to assess this patient’s coronary artery disease risk?

 

  1. Coronary artery calcium score
  2. C-reactive protein
  3. Exercise echocardiography
  4. Myocardial perfusion imaging

 

 

 

  1. Which risk assessment for coronary artery disease is recommended for all female patients?

 

  1. Coronary artery calcium score
  2. Electrocardiogram
  3. Exercise stress test
  4. Framingham risk score

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 117: Abdominal Aortic Aneurysm Test Bank

Multiple Choice

 

 

  1. A patient reports abdominal and back pain with anorexia and nausea. During an exam, the provider notes a pulsatile abdominal mass. What is the initial action?

 

  1. Immediate referral to a thoracic surgeon
  2. Ordering computerized tomography angiography
  3. Scheduling an MRI to evaluate for aortic disease
  4. Ultrasound of the mass to determine size

 

 

  1. A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly- controlled hypertension, and decompensated heart failure. What is the recommendation for treatment for this patient?

 

  1. Endovascular stent grafting of the aneurysm
  2. Immediate open surgical repair of the aneurysm
  3. No intervention is necessary for this patient
  4. Serial ultrasonographic surveillance of the aneurysm

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 118: Cardiac Arrhythmias Test Bank

Multiple Choice

 

 

  1. A patient reports sustained, irregular heart palpitations. What is the most likely cause of these symptoms?

 

  1. Anemia
  2. Atrial fibrillation
  3. Extrasystole
  4. Paroxysmal attacks

 

 

  1. An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart rate of 70 beats per minutes. What will the provider do next?

 

  1. Evaluate the patient’s orthostatic vital signs
  2. Monitor the patient’s heart rate while the patient is bearing down
  3. Order an electrocardiogram and exercise stress test
  4. Reassure the patient that the symptoms are non-cardiac in origin

 

 

 

  1. A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a heart rate of 225 beats per minute. The provider notifies transport to take the child to the emergency department. What initial intervention may be attempted in the clinic?

 

  1. Administration of intravenous adenosine
  2. Giving a beta blocker

 

Test Bank                                                                                                                                                2

 

  1. Providing a loading dose of digoxin
  2. Using a vagal maneuver or carotid massage

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 119: Carotid Artery Disease Test Bank

Multiple Choice

 

 

  1. According to current research, which are associated with a decreased incidence of stroke?

 

  1. ≧7 servings of fruits and vegetables per day
  2. B-complex vitamin supplements
  3. Intensive insulin therapy in type 1 diabetes
  4. Low-sugar soda
  5. Mediterranean diet

 

 

 

  1. During a routine health maintenance examination, the provider auscultates a cervical bruit. The patient denies syncope, weakness, or headache. What will the provider do, based on this finding?

 

  1. Order a carotid duplex ultrasound
  2. Order catheter-based angiography
  3. Refer the patient to a neurosurgeon
  4. Schedule a computed tomography angiography

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 120: Chest Pain and Coronary Artery Disease Test Bank

Multiple Choice

 

 

  1. A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The provider administers a nitroglycerin tablet which does not relieve the discomfort. What is the next action?

 

  1. Administer a second nitroglycerin tablet
  2. Give the patient a beta blocker medication
  3. Prescribe a calcium channel blocker mediation
  4. Start aspirin therapy and refer the patient to a cardiologist

 

 

  1. A patient is brought to an emergency department with symptoms of acute ST-segment elevation MI (STEMI). The nearest hospital that can perform percutaneous coronary intervention (PCI) is 3 hours away. What is the initial treatment for this patient?

 

  1. Administer heparin
  2. Give the patient an oral beta blocker
  3. Initiate fibrinolytic treatment
  4. Transfer to the PCI-capable institution

 

 

 

  1. Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular disease are those with a history of

 

  1. a 10 year risk score of 5% and an LDL of 165 mg/dL.

 

Test Bank                                                                                                                                                2

 

  1. a 10 year risk score of 8% with an LDL of 80 mg/dL.
  2. a low-density lipoprotein (LDL) level >190 mg/dL.
  3. diabetes and an LDL between 40 and 70 mg/dL.
  4. previous myocardial

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 121: Heart Failure Test Bank

Multiple Choice

 

 

  1. A patient who has heart failure with reduced ejection fraction will have which symptoms?

 

  1. Dyspnea and fatigue without volume overload
  2. Impairment of ventricular filling and relaxation
  3. Mild, exertionally related dyspnea
  4. Pump failure from left ventricular systolic dysfunction

 

 

 

  1. A patient who has been diagnosed with heart failure for over a year reports being comfortable while at rest and experiences palpitations and dyspnea when walking to the bathroom. Which classification of heart failure is appropriate based on these symptoms?

 

  1. Class I
  2. Class II
  3. Class III
  4. Class IV

 

 

 

  1. A patient who has Class II heart failure is taking an ACE inhibitor and reports a recurrent cough that does not interfere with sleep or activity. What will the provider do initially to manage this patient?

 

  1. Assess serum potassium and sodium immediately

 

Test Bank                                                                                                                                                2

 

  1. Discontinue the ACE inhibitor and prescribe an ARB
  2. Provide reassurance that this is a benign side effect
  3. Withhold the drug and evaluate renal and pulmonary function

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 122: Hypertension Test Bank

Multiple Choice

 

 

  1. Which are causes of secondary hypertension?

 

  1. Increased salt intake
  2. Isometric exercises
  3. Nonsteroidal anti-inflammatory drugs
  4. Oral contraceptives
  5. Sleep apnea

 

 

  1. A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to evaluate this patient?

 

  1. Assess serum cortisol levels
  2. Continue to monitor blood pressure at each health maintenance visit
  3. Order urinalysis, CBC, BUN, and creatinine
  4. Refer to a specialist for a sleep study

 

 

 

  1. An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred vision and shortness of breath. The provider notes a blood pressure of 185/115. What is the recommended action for this patient?

 

Test Bank                                                                                                                                                2

 

  1. Add a beta blocker to the patient’s regimen
  2. Admit to the hospital for evaluation and treatment
  3. Increase the dose of the thiazide medication
  4. Prescribe a calcium channel blocker

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 123: Infective Endocarditis Test Bank

Multiple Choice

 

 

  1. A patient has infective endocarditis and is being treated with empiric antibiotics after blood cultures are inconclusive. The patient develops a severe headache along with transient neurologic changes. What is the likely cause of these symptoms?

 

  1. Extra-cardiac abscess formation
  2. Haemophilus infection
  3. Mycotic aneurysm
  4. Rheumatic heart fever

 

 

  1. A patient has native valve endocarditis. While blood cultures are pending, which antibiotics will be ordered as empiric treatment?

 

  1. A beta-lactamase resistant penicillin and an antifungal drug
  2. Imipenem-cilastin and ampicillin
  3. Penicillin and an aminoglycoside antibiotic
  4. Vancomycin and quinupristin-dalfopristin

 

 

 

  1. A patient who is on renal dialysis is diagnosed with infective endocarditis. What causative organisms are more likely in this patient?

 

Test Bank                                                                                                                                                2

 

 

  1. Enterococcal organisms
  2. Neisseria gonorrhea
  3. Pseudomonas aeruginosa
  4. Staphylococcus aureus

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 124: Myocarditis Test Bank

Multiple Choice

 

 

  1. A patient who is a runner is diagnosed with viral myocarditis and asks when he may begin exercising again. What will the provider tell this patient?

 

  1. Exercise is contraindicated for life
  2. Exercise may resume when symptoms subside
  3. He may resume exercise in 6 months
  4. He must be symptom-free for 1 year

 

 

  1. Which test is diagnostic for diagnosing myocarditis?

 

  1. Echocardiogram
  2. Electrocardiogram
  3. Endomyocardial biopsy
  4. Magnetic resonance imaging

 

 

 

  1. A previously healthy patient develops myocarditis and presents with sudden onset of dyspnea, fatigue, and orthopnea. A family history is negative. The provider suspects myocarditis. What is the most likely etiology for this patient?

 

  1. Autoimmune disorder
  2. Bacterial infection
  3. Protozoal infection
  4. Viral infection

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 125: Peripheral Arterial and Venous Insufficiency Test Bank

Multiple Choice

 

 

  1. An elderly female without prior history of cardiovascular disease reports lower leg soreness and fatigue when shopping or walking in the neighborhood. The primary care provider notes decreased pedal pulses bilaterally. Which test will the provider order initially to evaluate for peripheral arterial disease based on these symptoms?

 

  1. Digital subtraction angiography
  2. Doppler ankle, arm index
  3. Magnetic resonance angiography
  4. Segmental limb pressure measurement

 

 

  1. A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30 minutes or more. What the does provider suspect as the cause for these symptoms?

 

  1. Buerger’s disease
  2. Cauda equina syndrome
  3. Diabetic neuropathy
  4. Peripheral arterial disease

 

 

 

  1. A patient is diagnosed with PAD and elects not to have angioplasty after an angiogram reveals partial obstruction in lower extremity arteries. What will the provider recommend to help with relief of symptoms in this patient?

 

  1. Daily aspirin therapy to prevent clotting
  2. Statin therapy with clopidogrel

 

Test Bank                                                                                                                                                2

 

  1. Walking slowly for 15 to 20 minutes twice daily
  2. Walking to the point of pain each day

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 126: Valvular Heart Disease and Cardiac Murmurs Test Bank

Multiple Choice

 

 

  1. Which are factors can cause a heart murmur?

 

  1. Backward flow through a septal defect
  2. Backward flow into a normal vessel
  3. Forward flow into a dilated vessel
  4. High rates of flow through a normal valve
  5. Low rates of flow into a cardiac chamber

 

 

 

  1. A young female patient has known mitral valve prolapse. During a routine health maintenance exam, the provider notes an apical systolic murmur and a midsystolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What will the provider do?

 

  1. Admit the patient to the hospital for evaluation and treatment
  2. Consult with the cardiologist to determine appropriate diagnostic tests
  3. Continue to monitor the patient every 3 years
  4. Reassure the patient that these findings are expected

 

 

  1. A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal border. The provider determines that the murmur decreases in intensity when the patient changes from standing to squatting and increases in intensity with the Valsalva maneuver. Which cause will the provider suspect for this murmur?

 

  1. Aortic stenosis

 

Test Bank                                                                                                                                                2

 

  1. Hypertrophic cardiomyopathy
  2. Mitral valve prolapse
  3. Tricuspid regurgitation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 127: Abdominal Pain and Infections Test Bank

Multiple Choice

 

 

  1. A patient is in clinic for evaluation of sudden onset of abdominal pain. The provider palpates a pulsatile, painful mass between the xiphoid process and the umbilicus. What is the initial action?

 

  1. Order a CBC, type and crossmatch, electrolytes, and renal function tests
  2. Perform an ultrasound examination to evaluate the cause
  3. Schedule the patient for an aortic angiogram
  4. Transfer the patient to the emergency department for a surgical consult

 

 

 

  1. Which symptoms in a patient with abdominal pain are suggestive of appendicitis?

 

  1. Abdominal rigidity along with pain
  2. Pain accompanied by low-grade fever
  3. Pain occurring prior to nausea and vomiting
  4. Pain that begins in the left lower quadrant
  5. Prolonged duration of right lower quadrant pain

 

 

 

  1. An adult patient has intermittent, crampy abdominal pain with vomiting. The provider notes marked abdominal distention and hyperactive bowel sounds. What will the provider do initially?

 

  1. Admit the patient to the hospital for consultation with a surgeon
  2. Obtain upright and supine radiologic views of the abdomen

 

Test Bank                                                                                                                                                2

 

  1. Prescribe an antiemetic and recommend a clear liquid diet for 24 hours
  2. Schedule the patient for a barium swallow and enema

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 128: Anorectal Complaints Test Bank

Multiple Choice

 

 

  1. What are recommendations for patients with chronic pruritis ani?

 

  1. Application of a topical antihistamine
  2. Applying a of 1% hydrocortisone cream for several months
  3. Avoid tight-fitting or non-breathable clothing
  4. Avoiding perfumed soaps and toilet papers
  5. Using a hair dryer on the cool setting to control itching

 

 

 

  1. A patient reports anal pruritis and occasional bleeding with defecation. An examination of the perianal area reveals external hemorrhoids around the anal orifice as the patient is bearing down. The provider orders a colonoscopy to further evaluate this patient. What is the treatment for this patient’s symptoms?

 

  1. A high-fiber diet and increased fluid intake
  2. Daily laxatives to prevent straining with stools
  3. Infiltration of a local anesthetic into the hemorrhoid
  4. Referral for possible surgical intervention

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 129: Cholelithiasis and Cholecystitis Test Bank

Multiple Choice

 

 

  1. A patient has sudden onset of right upper quadrant and epigastric abdominal pain with fever, nausea, and vomiting. The emergency department provider notes yellowing of the sclerae. What is the probable cause of these findings?

 

  1. Acute acalculous cholecystitis
  2. Chronic cholelithiasis
  3. Common bile duct obstruction
  4. Infectious cholecystitis

 

 

 

  1. A patient with a previous history of liver disease has bile duct obstruction. Which procedure will be used for this patient?

 

  1. Chemical dissolution of the gallstone
  2. Lithotripsy
  3. Open cholecystectomy
  4. Laparoscopic cholecystectomy

 

 

 

  1. A 30-year-old woman has right upper quadrant abdominal pain, nausea, and vomiting. Which diagnostic test will the provider order?

 

  1. Abdominal CT with contrast
  2. Abdominal ultrasound
  3. MRI of the abdomen
  4. Plain abdominal radiographs

 

Test Bank                                                                                                                                                2

 

 

 

 

  1. A patient has fever, nausea, vomiting, anorexia, and right upper quadrant abdominal pain. An ultrasound is negative for gallstones. Which action is necessary to treat this patient’s symptoms?

 

  1. Empiric treatment with antibiotics
  2. Hospitalization for emergent treatment
  3. Prescribing ursodeoxycholic acid
  4. Supportive care with close follow-up

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 130: Cirrhosis Test Bank

Multiple Choice

 

 

  1. A patient who is a chronic alcoholic reports weight loss, pruritis, and fatigue and the provider suspects cirrhosis of the liver. The patient’s urine and stools appear normal. What do these findings indicate?

 

  1. Early liver cirrhosis
  2. Late liver cirrhosis
  3. Liver failure and ascites
  4. Probably viral hepatitis

 

 

 

  1. A patient with cirrhosis develops ascites. Which medication will be ordered initially to improve symptoms?

 

  1. Cephalosporin
  2. Furosemide
  3. Lactulose
  4. Spironolactone

 

 

 

  1. A patient has fibrotic liver disease and a liver biopsy shows micronodular cirrhosis. What is the most common cause of this form of cirrhosis?

 

  1. Alcoholism
  2. Hepatitis C
  3. Hepatocellular carcinoma
  4. Right-sided heart failure

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 131: Constipation Test Bank

Multiple Choice

 

 

  1. A patient is diagnosed with chronic constipation who uses polyethylene glycol, reports increased abdominal discomfort with nausea and vomiting. What is the initial action by the provider?

 

  1. Increase the dose of polyethylene glycol
  2. Obtain radiographic abdominal studies
  3. Perform a stool culture and occult blood
  4. Refer to a specialist for colonoscopy

 

 

 

  1. A patient reports a decrease in the frequency of stools and asks about treatment for constipation. Which findings are part of the Rome III criteria for diagnosing constipation?

 

  1. Feeling of incomplete evacuation
  2. Fewer than 5 stools per week
  3. Lumpy stools
  4. Presence of irritable bowel syndrome
  5. Symptoms present for 3 months

 

 

 

  1. A patient has recurrent constipation which improves with laxative use but returns when laxatives are discontinued. Which pharmacologic treatment will the provider recommend for long-term management?

 

  1. Bisacodyl

 

Test Bank                                                                                                                                                2

 

  1. Docusate sodium
  2. Methylcellulose
  3. Mineral oil

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 132: Diarrhea, Noninfectious Test Bank

Multiple Choice

 

 

  1. Which types of chronic noninfectious diarrhea will cause fatty stools?

 

  1. Celiac disease
  2. Cystic fibrosis
  3. Diabetes mellitus
  4. Lactose intolerance
  5. Pancreatic insufficiency

 

 

 

  1. A patient develops acute diarrhea and then comes to clinic two weeks later reporting profuse watery, bloody diarrheal stools 6 to 8 times daily. The provider notes a toxic appearance with moderate dehydration. Which test is indicated to diagnose this cause?

 

  1. Qualitative and quantitative fecal fat
  2. Stool collection for 24-hour stool pH
  3. Stool sample for C. difficile toxin
  4. Wright stain of stool for white blood cells

 

 

 

  1. A patient who developed chronic diarrhea after gastric surgery asks what can be done to mitigate symptoms. What will the provider recommend initially?

 

  1. A diet high in carbohydrates
  2. Avoiding liquids with meals
  3. Empiric antibiotic therapy
  4. Probiotic supplements

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 133: Diverticular Disease Test Bank

Multiple Choice

 

 

  1. A patient has intermittent left-sided lower abdominal pain and fever associated with bloating and constipation alternating with diarrhea. The provider suspects acute diverticulitis. Which tests will the provider order?

 

  1. Barium enema examination
  2. CT scan of abdomen and pelvis
  3. Plain abdominal radiographs
  4. Rigid sigmoidoscopy
  5. Stool for occult blood

 

 

 

  1. A patient has a history of diverticular disease and asks what can be done to minimize acute symptoms. What will the practitioner recommend to this patient?

 

  1. Avoiding saturated fats and red meat
  2. Consuming a diet high in fiber
  3. Taking an anticholinergic medication
  4. Using bran to replace high-fiber foods

 

  1. A patient who has a history of diverticular disease has left-sided pain and reports seeing blood in the stool. What is an important intervention for these symptoms?

 

  1. Ordering a CBC and stool for occult blood
  2. Prescribing an antispasmodic medication
  3. Referring the patient for a lower endoscopy
  4. Reminding the patient to eat a high-fiber diet

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 134: Dysphagia Test Bank

Multiple Choice

 

 

  1. Which diagnostic study is best to evaluate a swallowing disorder?

 

  1. CT of the head and neck
  2. Electroglottography
  3. Electromyoscopy
  4. Videofluoroscopy

 

 

 

  1. A patient has a feeding disorder after a stroke that causes disordered tongue function and impaired laryngeal closure. What intervention will be helpful to reduce complications in this patient?

 

  1. Surface electrical stimulation
  2. Teaching head rotation
  3. Thickened liquids
  4. Thinning liquids

 

 

 

  1. An elderly patient has recent weight loss and the patient’s spouse reports noticing coughing and choking when eating. What is the likely cause of this presentation?

 

 

  1. Esophageal dysphagia

 

Test Bank                                                                                                                                                2

 

  1. Oral stage dysphagia
  2. Pharyngeal dysphagia
  3. Xerostomia causing dysphagia

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 135: Gastroesophageal Reflux Disease Test Bank

Multiple Choice

 

 

  1. Which medications may increase the prevalence of GERD?

 

  1. Aspirin
  2. Benzodiazepines
  3. Calcium antagonists
  4. Hormone replacements
  5. Oral contraceptives

 

 

 

  1. A patient has been taking a proton pump inhibitor (PPI) for several months to treat GERD with rebound symptoms when discontinuing the medication. To minimize long-term side effects of the PPI, what regimen may be ordered?

 

  1. Alternate-day dosing of the PPI
  2. Switching to a histamine-2 receptor antagonist (H2RA)
  3. Taking a PPI and H2RA at different times a day
  4. Twice daily dosing of the PPI

 

 

 

  1. A patient experiences a sharp pain with swallowing just under the sternum. This is more commonly associated with which condition?

 

  1. Hiatal hernia
  2. Infectious esophagitis
  3. Peptic stricture
  4. Schatzki ring

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 136: Gastrointestinal Hemorrhage Test Bank

Multiple Choice

 

 

  1. A patient has both occasional “coffee ground” emesis and melena stools. What is the most probably source of bleeding in this patient?

 

  1. Hepatic
  2. Lower GI
  3. Rectal
  4. Upper GI

 

 

 

  1. What is an initial action when admitting a patient to the hospital who has a GI bleed, hypotension, and a hematocrit decrease of 6% from baseline?

 

  1. Administer packed red blood cells
  2. Place a Foley catheter to monitor output
  3. Place two large-bore intravenous lines
  4. Prepare for surgical repair of the bleed

 

 

 

  1. A 50-year-old, previously healthy patient has developed chronic gastritis. What is the most likely cause of this condition?

 

  1. pylori infection
  2. NSAID use
  3. Parasite infestation
  4. Viral gastroenteritis

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 137: Hepatitis Test Bank

Multiple Choice

 

 

  1. A patient who is asymptomatic tests positive for the hepatitis C virus. What will the provider tell the patient about managing this illness?

 

  1. A rapidly fulminant disease ending with cirrhosis is likely
  2. Administering immunoglobulins helps shorten the course
  3. Pegylated interferon is given for 6 to 12 months
  4. Treatment is supportive since the infection is self-limiting

 

 

 

  1. Which form of hepatitis virus is rapidly spread via the fecal-oral route?

 

  1. Hepatitis A
  2. Hepatitis B
  3. Hepatitis C
  4. Hepatitis D

 

 

  1. A recovering chronic alcoholic reports nausea, vomiting, diarrhea, and abdominal discomfort. A physical examination is negative for jaundice or ascites. What will the provider do initially?

 

  1. Obtain a bilirubin level and prothrombin time
  2. Order a complete blood count and liver function tests
  3. Reassure the patient that this is likely a viral gastroenteritis
  4. Refer the patient to a specialist for evaluation and treatment

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 138: Inflammatory Bowel Disease Test Bank

Multiple Choice

 

 

  1. A patient is diagnosed with ulcerative colitis. Which medication will be prescribed initially to establish remission?

 

  1. Azathioprine
  2. Budesonide
  3. Infliximab
  4. Sulfasalazine

 

 

 

  1. A patient reports lower abdominal cramping and occasional blood in stools. The provider suspects inflammatory bowel disease. Which test will the provider order to determine whether the patient has ulcerative colitis or Crohn’s disease?

 

  1. Barium enema
  2. Colonoscopy
  3. Genetic testing
  4. Small bowel series

 

 

 

  1. Which are characteristic of Crohn’s disease? Select all that

 

  1. Fistulous tracts may occur as disease
  2. Half of patients will not have significant remission of

 

Test Bank                                                                                                                                                2

 

  1. Inflammation affects all layers of the intestinal tract
  2. The disease may be limited to the small
  3. The inflammation is diffuse and

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 139: Irritable Bowel Syndrome Test Bank

Multiple Choice

 

 

  1. A patient has irritable bowel syndrome with alternating diarrhea and constipation and asks the provider about dietary changes that may help with symptoms. What will the provider recommend?

 

  1. Avoiding all beverages containing caffeine
  2. Consuming a high fiber diet
  3. Eliminating all foods containing dairy products
  4. Keeping a food and symptom diary

 

 

 

  1. Which symptom must be present for a diagnosis of irritable bowel syndrome?

 

  1. Abdominal pain
  2. Bloating
  3. Constipation
  4. Diarrhea

 

 

  1. What is the probable underlying pathology of irritable bowel syndrome, according to research over the last decade?

 

  1. Alteration in processing of sensory information
  2. Changes in intestinal secretory mucosa
  3. Intestinal tissue disease
  4. Malabsorption of specific nutrients

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 140: Jaundice Test Bank

Multiple Choice

 

 

  1. A patient has an elevated indirect bilirubin. Which condition may be causing this symptom?

 

  1. Alcoholic cirrhosis
  2. Cholelithiasis
  3. Hemolytic anemia
  4. Viral hepatitis

 

 

 

  1. A patient who has jaundice has bright orange urine. What is a likely cause of this jaundice?

 

  1. Bile duct obstruction
  2. Blood transfusion reaction
  3. Defective erythropoiesis
  4. Sickle cell anemia

 

 

  1. A patient has jaundice and bilirubin testing reveals elevated direct bilirubin. Which subsequent testing may help determine the cause of these findings?

Select all that apply.

 

  1. Complete blood count
  2. Liver function tests
  3. Renal function tests
  4. Serologic viral tests
  5. Serum iron and ferritin

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 141: Nausea and Vomiting Test Bank

Multiple Choice

 

 

  1. A patient has a recent episode of vomiting and describes the vomitus as containing mostly gastric juice. What does this symptom suggest?

 

  1. Bile duct obstruction
  2. Gastritis
  3. Peptic ulcer
  4. Small bowel obstruction

 

 

 

  1. A patient has nausea associated with chemotherapy. Which agent will be prescribed?

 

  1. Diphenhydramine
  2. Meclizine
  3. Ondansetron
  4. Scopolamine

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 142: Pancreatitis Test Bank

Multiple Choice

 

 

  1. Which is the most common cause of pancreatitis in the United States?

 

  1. Ethyl alcohol
  2. Gallstones
  3. Hyperlipidemia
  4. Trauma

 

 

 

  1. A patient reports a sudden onset of constant, sharp abdominal pain radiating to the back. The examiner notes both direct and rebound tenderness with palpation of the abdomen. What is the significance of this finding?

 

  1. Compression of the common bile duct
  2. Presence of a pancreatic pseudocyst
  3. Retroperitoneal hemorrhage
  4. Severe acute pancreatitis with peritonitis

 

 

  1. The provider suspects that a patient has chronic pancreatitis. Which diagnostic tests will be most helpful to confirm this diagnosis?

 

  1. Blood glucose and fecal fat
  2. Complete blood count
  3. Liver function tests
  4. Serum amylase and lipase levels

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 143: Tumors of the Gastrointestinal Tract Test Bank

Multiple Choice

 

 

  1. A patient with a history of esophageal reflux reports difficulty swallowing. The provider notes fixed cervical and axillary lymphadenopathy on exam. What is the significance of these findings if esophageal carcinoma is suspected?

 

  1. A tumor is likely confined to the upper
  2. Lymphadenopathy indicates advanced
  3. The prognosis for cure is
  4. This type of cancer responds well to

 

 

 

  1. A patient is diagnosed with cancer of the colon and is scheduled for surgical resection. A carcinoembryonic antigen (CEA) test prior to surgery is not elevated. What is the significance of this finding?

 

  1. A negative CEA indicates a reduced need for
  2. The CEA should be repeated every 3
  3. The test is not informative and will not be
  4. This result indicates a better prognosis for

 

 

 

  1. A patient is diagnosed with gastric cancer after presenting with cachexia, small bowel obstruction, hepatomegaly, and ascites. What will the provider tell this patient about treatment and possible cure?

 

  1. A complete resection will be
  2. Chemotherapy is the only

 

Test Bank                                                                                                                                                2

 

  1. Palliative resection may be
  2. Radiation therapy is preferred for

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 144: Peptic Ulcer Disease Test Bank

Multiple Choice

 

 

  1. A patient has persistent epigastric pain occurring 2 to 3 hours after a meal. Which test is definitive for diagnosis peptic ulcer in this patient?

 

  1. Barium swallow with radiography
  2. Breath test or stool antigen testing for H. pylori
  3. Endoscopy with biopsy of gastric mucosa
  4. Physical exam with percussion of the upper abdomen

 

 

 

  1. What is the best treatment for H. pylori-related peptic ulcer disease?

 

  1. H2RA and clarithromycin for 14 days
  2. H2RA, bismuth, metronidazole, and tetracycline for 10 to 14 days
  3. PPI and clarithromycin for 14 days
  4. PPI, amoxicillin, and clarithromycin for 10 days

 

 

 

  1. A patient who has been taking an NSAID for osteoarthritis pain has peptic ulcer disease. What is the initial step in treating this patient?

 

  1. Discontinue the NSAID
  2. Order prostaglandin therapy
  3. Prescribe a proton pump inhibitor
  4. Recommend an H2 receptor antagonist

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 145: Incontinence Test Bank

Multiple Choice

 

 

  1. The provider is evaluating a patient for potential causes of urinary incontinence and performs a postvoid residual (PVR) test which yields 30 mL of urine. What is the interpretation of this result?

 

  1. The patient may have overflow
  2. The patient probably has a
  3. This is a normal
  4. This represents incomplete

 

 

 

  1. The provider is counseling a patient who has stress incontinence about ways to minimize accidents. What will the provider suggest initially?

 

  1. Increasing fluid intake to dilute the urine
  2. Referral to a physical therapist
  3. Taking pseudoephedrine daily
  4. Voiding every 2 hours during the day

 

 

 

  1. The daughter of an elderly, confused female patient reports that her mother is having urinary incontinence several times each day. What will the provider do initially?

 

  1. Obtain a urine sample for urinalysis and possible culture
  2. Order serum creatinine and blood urea nitrogen tests
  3. Perform a bladder scan to determine distention and retention
  4. Tell the daughter that this is expected given her mother’s age and confusion

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 146: Prostate Cancer Test Bank

Multiple Choice

 

 

  1. An older male patient reports urinary frequency, back pain, and nocturia. A dipstick urinalysis reveals hematuria. What will the provider do next to evaluate this condition?

 

  1. Order a PSA and perform a digital rectal exam
  2. Refer for a biopsy
  3. Refer the patient to a urologist
  4. Schedule a transurethral ultrasound

 

 

  1. An older male patient has a screening PSA which is 12 ng/mL. What does this value indicate?

 

  1. A normal result
  2. Benign prostatic hypertrophy
  3. Early prostate cancer
  4. Prostate cancer

 

 

 

  1. A patient is diagnosed with prostate cancer and diagnostic testing reveals disease that has gone past the prostatic capsule without evidence of metastasis. The patient does not wish to undergo treatment. What will the provider tell this patient?

 

  1. Chemotherapy is indicated to provide cure for this
  2. Monitoring PSA with regular DSE is an acceptable
  3. Palliative radiation therapy is necessary to improve quality of
  4. This level of disease requires intervention with hormonal

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 147: Prostatic Hyperplasia (Benign) Test Bank

Multiple Choice

 

 

  1. A male patient reports nocturia and daytime urinary frequency and urgency without changes in the force of the urine stream. What is the likely cause of this?

 

  1. Bladder outlet obstruction
  2. Lower urinary tract symptoms
  3. Prostate cancer
  4. Urinary tract infection

 

 

 

  1. A 70-year-old male reports urinary hesitancy, post-void dribbling, and a diminished urine stream. A digital rectal exam reveals an enlarged prostate gland that feels rubbery and smooth. Which tests will the primary care provider order based on these findings?

 

  1. Bladder scan for post-void residual
  2. PSA and bladder imaging
  3. Urinalysis and serum creatinine
  4. Urine culture and CBC with differential

 

 

 

  1. A patient has been taking terazosin daily at bedtime to treat BPH and reports persistent daytime dizziness. What will the provider do?

 

  1. Prescribe finasteride instead of terazosin
  2. Recommend taking the medication in the morning

 

Test Bank                                                                                                                                                2

 

  1. Suggest using herbal preparations
  2. Switch the prescription to doxazosin

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 148: Proteinura and Hematuria Test Bank

Multiple Choice

 

 

  1. An older male patient reports gross hematuria but denies flank pain and fever. What will the provider do to manage this patient?

 

  1. Monitor blood pressure closely
  2. Obtain a urine culture
  3. Perform a 24-hour urine collection
  4. Refer for cystoscopy and imaging

 

 

 

  1. A pregnant woman at 30 weeks gestation has proteinuria. What will the provider do next?
  2. Evaluate her blood pressure
  3. Monitor serum glucose for gestational diabetes
  4. Perform a 24-hour urine collection

Reassure her that this normal at this stage of pregnancy

 

 

  1. A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract infection. After treatment for the UTI, what testing is indicated for this patient?

 

  1. 24-hour urine collection to evaluate for glomerulonephritis
  2. Bladder scan
  3. No testing if hematuria is resolved
  4. Voiding cystourethrogram

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 149: Renal Failure Test Bank

Multiple Choice

 

 

  1. A primary care provider sees a new patient who reports having a diagnosis of chronic kidney disease for several years. The patient is taking one medication for hypertension which has been prescribed since the diagnosis was made. The provider orders laboratory tests to evaluate the status of this patient. Which laboratory finding indicates a need to refer the patient to a nephrologist?

 

  1. ACR of 325 mg/g
  2. Blood pressure of 145/85 mm Hg
  3. GFR of 35
  4. Urine RBC of 15/hpf

 

 

 

  1. Which tests should be monitored regularly in order to monitor for complications of chronic renal disease?

Select all that apply.

 

  1. Liver enzymes
  2. Parathyroid hormone levels
  3. Serum glucose
  4. Serum lipids
  5. Vitamin D levels

 

 

  1. Which is a pre-renal cause of acute kidney injury?

 

  1. Anaphylactic shock
  2. Hydronephrosis

 

Test Bank                                                                                                                                                2

 

  1. Hypertension
  2. Renal calculi

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 150: Sexual Dysfunction (Male) Test Bank

Multiple Choice

 

 

  1. The provider orders the oral phosphodiesterase type 5 inhibitor sildenafil to treat erectile dysfunction in a 65-year-old male patient. What will be included when teaching this patient about taking this medication?

Select all that apply.

 

  1. The medication is best taken on an empty
  2. The medication should be taken with a fatty food or
  3. The medication’s effects may last for 24 to 36
  4. This medication has a rapid onset and short duration of
  5. This medication may be taken once

 

 

 

  1. A 50-year-old man reports having erectile dysfunction. What is an important response by the provider when developing a plan of care for this patient?

 

  1. Considering testosterone hormone replacement therapy
  2. Evaluating the patient for cardiovascular disease
  3. Prescribing an oral phosphodiesterase type 5 inhibitor
  4. Referring the patient for psychotherapy and counseling

 

 

  1. Which is true about hypoactive sexual desire in older men?

 

  1. Hypoactive sexual desire in older men is related to sexual
  2. Hypoactive sexual desire is a conscious choice to avoid sexual
  3. Men with hypoactive sexual desire may have normal excitement and

 

Test Bank                                                                                                                                                2

 

  1. The most common type of sexual dysfunction is hypoactive sexual

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 151: Testicular Disorders Test Bank

Multiple Choice

 

 

  1. A young adult male reports a dull pain in the right scrotum and the provider notes a bluish color showing through the skin on the affected side. Palpation reveals a bag of worms on the proximal spermatic cord. What is an important next step in managing this patient?

 

  1. Anti-infective therapy with ceftriaxone or doxycycline
  2. Consideration of underlying causes of this finding
  3. Reassurance that this is benign and may resolve spontaneously
  4. Referral to an emergency department for surgical consultation

 

 

 

  1. An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric reflex. What is the most important intervention?

 

  1. Doppler ultrasound to assess testicular blood flow
  2. Immediate referral to the emergency department
  3. Prescribing anti-infective agents to treat the infection
  4. Transillumination to assess for a “blue dot” sign

 

 

 

  1. A 3-month-old male infant has edema and painless swelling of the scrotum. On physical examination, the provider is able to transilluminate the scrotum. What will the provider recommend?

 

  1. A Doppler ultrasound to evaluate the scrotal structures
  2. A short course of empiric antibiotic therapy

 

Test Bank                                                                                                                                                2

 

  1. Immediate referral to a genitourinary surgeon for repair
  2. Observation and reassurance that spontaneous resolution may occur

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 152: Urinary Calculi Test Bank

Multiple Choice

 

 

  1. A patient who has diabetes has symptoms consistent with renal stones. Which type of stone is most likely in this patient?

 

  1. Citrate
  2. Cysteine
  3. Oxalate
  4. Uric acid

 

 

 

  1. Which factors increase the risk of renal stones? Select all that

 

  1. Excess antacid use
  2. Snow skiing
  3. Strenuous exercise
  4. Surgical menopause
  5. Vitamin D excess

 

 

 

  1. A patient has acute renal colic, nausea, and vomiting and a urinalysis reveals hematuria, but is otherwise normal. A radiographic exam shows several radiopaque stones in the ureter which are less than 1 mm in diameter. What will the primary provider do initially to manage this patient?

 

  1. Obtain a consultation with a urology specialist
  2. Order a narcotic pain medication and increased oral fluids
  3. Prescribe desmopressin and a corticosteroid medication
  4. Prescribe nifedipine and hospitalize for intravenous antibiotics

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 153: Urinary Tract Infections and Sexually Transmitted Infections Test Bank

Multiple Choice

 

 

  1. A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine dipstick during a well patient exam. What type of urinary tract infection does this represent?

 

  1. Complicated
  2. Isolation
  3. Uncomplicated
  4. Unresolved

 

 

 

  1. An asymptomatic pregnant woman has a positive leukocyte esterase and positive nitrites on a urine dipstick screening. What will the provider do next?

 

  1. Admit to the hospital
  2. Obtain a urine culture
  3. Order a renal ultrasound
  4. Prescribe trimethoprim-sulfamethoxazole

 

 

 

  1. An asymptomatic female learns that her boyfriend has gonorrhea and asks about antibiotics. What will the provider recommend?

 

  1. Amoxicillin-clavulanate for 10 days
  2. Cultures and treatment if symptoms appear
  3. Empiric ceftriaxone and azithromycin
  4. Trimethoprim-sulfamethoxazole

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 154: Uropathies (Obstructive) and Tumors of the Genitourinary Tract (Kidneys, Ureters, and Bladder)

 

Test Bank Multiple Choice

 

  1. A patient has a partial urinary tract obstruction caused by benign prostatic hypertrophy. The patient reports increasing difficulty initiating a urine stream and occasional incontinence, but has not experienced a urinary tract infection. Which initial treatment will be ordered?

 

  1. A 5a-reductase inhibitor
  2. Surgical intervention
  3. Urinary catheterization
  4. Urinary diversion procedure

 

 

 

  1. A patient reports right sided flank pain and hematuria and the provider palpates a renal mass on the affected side. What is the probable treatment for this patient’s condition?

 

  1. Biologic response modifiers, including interleukin
  2. Ileal conduit urinary diversion surgery
  3. Nephron-sparing nephrectomy and chemotherapy
  4. Radiotherapy for palliation of metastatic lesions

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 155: Amenorrhea Test Bank

Multiple Choice

 

 

  1. A 16-year-old female has primary amenorrhea. A pregnancy test is negative. Further testing reveals a normal TSH and an elevated prolactin level. Which test will the provider order next?

 

  1. Clomiphene challenge test
  2. Magnetic resonance imaging
  3. Progesterone challenge test
  4. Serum dehydroepiandrosterone

 

 

 

  1. An adolescent female has amenorrhea. The provider notes short stature, neck webbing, and a pigeon chest deformity. Based on these symptoms, what is the underlying disorder causing this patient’s amenorrhea?

 

  1. Androgen insensitivity
  2. Hypothyroidism
  3. Polycystic ovarian disease
  4. Turner’s syndrome

 

 

  1. A 15-year-old female who participates in high school track and gymnastics is experiencing amenorrhea after having eight normal periods. A pregnancy test is negative. What may be included in management of this patient’s amenorrhea to restore normal periods?

 

Test Bank                                                                                                                                                2

 

Select all that apply.

 

  1. Calcium and vitamin D supplementation
  2. Clomiphene administration
  3. Combination oral contraceptives
  4. Dietician consultation
  5. Estriol therapy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 156: Bartholin’s Gland Cysts and Abscesses Test Bank

Multiple Choice

 

 

  1. An adolescent female reports a mass on her genitalia which is becoming increasingly painful. On exam, the provider notes an erythematous, edematous, tender mass lateral to the vestibule without discharge. What will the provider do initially?

 

  1. Obtain a consultation for biopsy of the lesion
  2. Perform a speculum examination of the vagina
  3. Prescribe empiric metronidazole twice daily
  4. Refer the patient for an incision and drainage and culture

 

 

 

  1. A patient has undergone surgical incision and drainage of a Bartholin’s cyst with insertion of a drain. What is an important aspect of care for this patient?

 

  1. Administration of antibiotics
  2. Education about long-term dyspareunia
  3. Teaching about reproductive sequelae
  4. Weekly follow-up monitoring

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 157: Breast Disorders Test Bank

Multiple Choice

 

 

  1. A woman who has just weaned her infant from breastfeeding develops signs of mastitis and is treated with antibiotics. At a follow up visit, the provider notes marked breast edema and erythema of the affected breast. What will the provider do next?

 

  1. Consult with a surgeon for I&D of the breast
  2. Counsel the patient to apply warm compresses
  3. Prescribe antibiotics to treat MRSA infection
  4. Refer the patient for an immediate biopsy

 

 

 

  1. A postmenopausal woman reports unilateral breast pain that she describes as sharp and burning and localized to one area. A breast examination reveals no dimpling, discharge, or masses. Which diagnostic test will the provider order?

 

  1. Bilateral mammography
  2. Focused ultrasound
  3. Hormone levels
  4. Needle biopsy

 

 

  1. A female patient is identified as having the BRCA mutation and she asks which intervention will reduce her risk of breast cancer the most? What will the provider tell her?

 

  1. Breast magnetic resonance imaging

 

Test Bank                                                                                                                                                2

 

  1. Clinical breast examination every 6 months
  2. Early childbearing and breastfeeding
  3. Prophylactic mastectomy and oophorectomy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 158: Chronic Pelvic Pain Test Bank

Multiple Choice

 

 

  1. A woman with chronic pelvic pain most likely has a gynecological cause for her symptoms. Which treatment will the provider recommend initially?

 

  1. Counseling and support
  2. Hysterectomy
  3. Neurostimulation
  4. Oral contraceptives

 

 

 

  1. Which underlying causes are related to chronic pelvic pain in women? Select all that

 

  1. Faulty posture
  2. Hepatitis
  3. Interstitial cystitis
  4. Physical abuse
  5. Recurrent pneumonia

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 159: Dysmenorrhea Test Bank

Multiple Choice

 

 

  1. A patient with primary dysmenorrhea has taken NSAIDs and COX-2 inhibitors without getting relief from symptoms. What will the provider suggest?

 

  1. A combined oral contraceptive
  2. Complementary therapies
  3. Intrauterine device implantation
  4. Narcotic analgesics as needed

 

 

 

  1. A 35-year-old woman without a previous history of dysmenorrhea reports lower pelvic pain and irregular bleeding between periods. What is the initial action in managing this patient?

 

  1. Obtaining a pelvic transvaginal ultrasound with saline infusion
  2. Ordering a CBC, erythrocyte sedimentation rate, and cultures
  3. Performing an abdominal, pelvic, and rectovaginal examination
  4. Prescribing a trial of nonsteroidal anti-inflammatory medications

 

 

 

  1. An adolescent female reports crampy pelvic pain radiating to the back, sacrum, and inner thighs during the first 2 days of each menstrual period, associated with nausea and loose tools. She asks about what causes these symptoms. What will the provider tell her?

 

  1. Excess prostaglandins, vasopressin will cause these symptoms
  2. Mechanical cervical obstruction or severe uterine flexion are likely causes
  3. Nulliparity and her young age are correlated with these symptoms

 

Test Bank                                                                                                                                                2

  1. The most likely cause at her age is anovulatory menstrual cycles

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 160: Dyspareunia Test Bank

Multiple Choice

 

 

  1. A previously healthy 22-year-old female reports pain in the rectovaginal area that occurs with sexual intercourse. What is the most likely cause of this patient’s discomfort?

 

  1. Atherosclerosis
  2. Endometriosis
  3. Inadequate lubrication
  4. Psychologic issues

 

 

 

  1. A perimenopausal woman reports a recent onset of moderate to severe pain with sexual intercourse. Which treatment will the provider prescribe initially to treat this pain?

 

  1. Botulism injections
  2. Topical corticosteroids
  3. Topical estrogen
  4. Water-based lubrication

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 161: Ectopic Pregnancy Test Bank

Multiple Choice

 

 

  1. A female patient has lower abdominal pain, nausea, and vomiting and reports missing a period 3 weeks prior. The patient reports using an intrauterine device for contraception. A serum B-hCG is 1500 mIU/mL. What will the provider do, based on these findings?

 

  1. Perform a transvaginal ultrasound
  2. Recheck the B-hCG level in 4 to 6 weeks
  3. Refer for a diagnostic laparoscopy
  4. Tell the patient that a viable pregnancy is likely

 

 

 

  1. A patient is determined to have a non-ruptured ectopic pregnancy within 1 week of a missed period. Which treatment will the specialist order?

 

  1. Laparoscopy
  2. Leucovorin rescue
  3. Methotrexate
  4. Mifepristone

 

 

  1. A patient has received methotrexate therapy for treatment of an ectopic pregnancy. What will the provider include when teaching this patient about this therapy?

Select all that apply.

 

Test Bank                                                                                                                                                2

 

  1. Avoid sexual intercourse for 3 months
  2. Do not consume alcohol for at least 3 months
  3. Long-term effects include lower fertility
  4. Pregnancy should be avoided in the future
  5. Refrain from taking vitamins containing folic acid

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 162: Fertility Control Test Bank

Multiple Choice

 

 

  1. A female calls the provider to report having unprotected sexual intercourse approximately 4 days prior. Which regimen will the provider recommend?

 

  1. Plan-B One-Step twice daily for 5 days
  2. Plan-B One-Step daily for 5 days
  3. Ulipristal Acetate taken one time
  4. Ulipristal Acetate twice daily for 3 days

 

 

 

  1. A woman has a history of migraines with aura and request oral contraceptives to prevent pregnancy. Which type of contraceptive will the provider recommend?

 

  1. Combination oral contraceptive
  2. Contraceptive implant
  3. Progestin-only contraception
  4. Transdermal combination product

 

 

  1. A woman who is taking oral contraceptive pills (OCPs) to prevent pregnancy calls the provider to report forgetting to take the pills for 4 days. She has not had sexual intercourse during that time. What will the provider recommend?

 

  1. Resume the pills and use a backup method the remainder of the cycle
  2. Stop the OCP, use an alternative method, and resume OCPs at the next cycle
  3. Take 2 pills daily for 4 days and use an alternative method for 4 days

 

Test Bank                                                                                                                                                2

  1. Use a morning after pill today and resume the OCPs now

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 163: Genital Tract Cancers Test Bank

Multiple Choice

 

 

  1. A woman asks about her risk of ovarian cancer. To best assess risk in this patient, what will the provider do first?

 

  1. Ask about parity and age of menarche
  2. Evaluate age of menopause
  3. Obtain a 3-generation family history
  4. Order testing for the BRCA gene

 

 

 

  1. A postmenopausal woman who is overweight and who has hyperlipidemia and a history of infertility develops vaginal bleeding and reports a feeling of pelvic pressure. The provider suspects a genital tract cancer and refers the patient for diagnostic evaluation. What is the likely cause of this woman’s symptoms?

 

  1. Cervical cancer
  2. Endometrial cancer
  3. Ovarian cancer
  4. Vaginal cancer

 

 

 

  1. A woman who has had routine Pap tests all of her adult life has an abnormal Pap. What will the provider tell her about this result?

 

  1. Colposcopy with biopsy is necessary
  2. She may have vaginal cancer
  3. She most likely has early cervical cancer
  4. The result most likely indicates HPV infection

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 164: Infertility Test Bank

Multiple Choice

 

 

  1. A couple who has been trying to conceive for over 9 months asks the provider about artificial reproductive therapy. When discussing risks and benefits associated with these methods, what will the provider include?

Select all that apply.

 

  1. Higher rates of pregnancy-induced hypertension
  2. Increased premature births
  3. Likelihood of increased infant birth weight
  4. More frequent multiple gestations
  5. Reduced risk of ovarian and breast cancers

 

 

 

  1. A provider is caring for a couple who are trying to conceive. To most accurately evaluate ovulation and luteal surge in the woman, what test will the provider recommend or perform?

 

  1. Basal body temperature
  2. Maintaining a menstrual calendar
  3. Plasma midluteal progesterone concentration level
  4. Urinary luteal hormone home kit

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 165: Menopause Test Bank

Multiple Choice

 

 

  1. A 45-year-old woman has gone 120 days without a menstrual period. A pregnancy test is negative. What will the provider do, based on this symptom?

 

  1. Evaluate for various causes of amenorrhea
  2. Reassure her that this can be normal
  3. Tell her she has developed early menopause
  4. Tell her that this is likely perimenopause

 

 

 

  1. A woman who has stopped having menstrual periods has vasomotor symptoms, but does not want to use hormone replacement therapy. What measures will the provider recommend? Select all that

 

  1. Avoiding caffeine
  2. Engaging in regular exercise
  3. Having a glass of wine each evening
  4. Keeping the house cool
  5. Trying herbal remedies

 

 

 

  1. Shortly after the onset of menopause, a woman begins to show signs of osteopenia. The provider orders oral Bazedoxifene combined with conjugated estrogen (BZA/CE). What will the provider tell her about the purpose of this treatment?

 

  1. It will improve calcium
  2. It will prevent further bone

 

Test Bank                                                                                                                                                2

 

  1. It will reduce the incidence of
  2. It will reverse bone

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 166: Pap Test Abnormalities Test Bank

Multiple Choice

 

 

  1. What is the benefit of using a liquid-based medium when performing a Pap test?

 

  1. It allows HPV, gonorrhea, and chlamydia testing with the same
  2. It is a more accurate test than the slide method of Pap
  3. It is not necessary to use endocervical cells to obtain
  4. It is predictive of the later development of cervical

 

 

 

  1. A young female has a Pap test which reveals atypical squamous cells of undetermined significance. What will the next step be in managing this patient?

 

  1. Colposcopy with biopsy
  2. Endometrial sampling
  3. Reflex HPV DNA test
  4. Repeat cytology in 12 months

 

 

 

  1. What is true about HPV infection in women?

 

  1. A single, isolated HPV infection will lead to cervical
  2. HPV subtypes causing genital warts indicate the likelihood of
  3. Most HPV lesions will resolve spontaneously without causing
  4. Most women with HPV infection will develop cervical

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 167: Pelvic Inflammatory Disease Test Bank

Multiple Choice

 

 

  1. Which are risk factors for pelvic inflammatory disease? Select all that

 

  1. Age under 25 years
  2. Cigarette smoking
  3. Tubal sterilization
  4. Using barrier methods of contraception
  5. Vaginal douching

 

 

 

  1. A sexually active female has symptoms of PID with fever. Cultures are pending. For outpatient treatment, what will the provider order?

 

  1. Ampicillin and doxycycline
  2. Cefotetan and doxycycline
  3. Clindamycin and gentamicin
  4. Rocephin, doxycycline, and metronidazole

 

 

  1. A female patient reports cramping, dysuria, low back pain, and nausea. A dipstick urinalysis is normal and a pregnancy test is negative. What will the provider do next?

 

  1. Obtain vaginal secretions for testing
  2. Refer for radiological studies
  3. Schedule for an endometrial biopsy
  4. Treat with empiric antibiotics

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 168: Sexual Dysfunction (Female) Test Bank

Multiple Choice

 

 

  1. A female patient with vaginal atrophy is prescribed a local estrogen therapy product with conjugated equine estrogen cream. What will the provider recommend as adjunctive therapy for this patient?

 

  1. Adding progesterone to the regimen
  2. Pelvic floor physical therapy
  3. Treatment with a testosterone patch
  4. Trigger point injections

 

 

 

  1. What is a possible cause of decreased arousal, libido, and orgasm in a postmenopausal woman?

 

  1. Diminished testosterone
  2. Endometriosis
  3. Low estrogen levels
  4. Uterine prolapse

 

 

 

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 169: Unplanned Pregnancy Test Bank

Multiple Choice

 

 

  1. In order to help prevent unplanned pregnancies, which group of providers may make the most impact by providing contraceptive counseling to women?

 

  1. Counselors in STI clinics
  2. Gynecologists
  3. Practitioners in walk-in clinics
  4. Primary care providers

 

 

 

  1. An adolescent female calls a primary care clinic to report that she has missed two periods and is having morning nausea and vomiting. What will the provider suggest?

 

  1. Coming to the clinic for pregnancy testing
  2. Making an appointment with a gynecologist
  3. Purchasing a home pregnancy test kit
  4. Referral to a community health clinic

 

 

 

  1. A provider sees a woman who has just learned she is pregnant with an unplanned pregnancy. What is an initial step in helping this woman make decisions about his pregnancy?

 

  1. Actively listen to the woman’s concerns and questions
  2. Ask the mother if the father of the baby will be involved
  3. Make a referral to an obstetrician for more informatio
  4. Offer information about both adoption and abortion

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 170: Vulvar and Vaginal Disorders Test Bank

Multiple Choice

 

 

  1. A female patient reports vulvar pruritus and dyspareunia. The provider notes white papules on the vulva with thinning of the epithelium. What condition does the provider suspect?

 

  1. Bartholin’s duct cyst
  2. Lichen sclerosis
  3. Sexually transmitted infection
  4. Vulvar psoriasis

 

 

 

  1. A sexually active young female reports vaginal discharge and moderate vulvovaginal irritation. The examination reveals a white, non-inflammatory discharge adhering to the vaginal walls, clue cells on microscopic examination and a positive KOH whiff test. What will the provider do next?

 

  1. Obtain cultures of the vaginal discharge
  2. Order a gynecologic referral for evaluation and treatment
  3. Prescribe metronidazole 500 mg for 7 days
  4. Screen the patient for gonorrhea and chlamydia

 

 

 

  1. A postmenopausal woman is diagnosed with lichen planus. After several weeks of treatment with a potent corticosteroid ointment, the woman reports improvement in itching, but states that she has extreme vaginal dryness. What will the provider recommend?

 

  1. Increasing the frequency of the corticosteroid application
  2. Taking diphenhydramine daily at bedtime

 

Test Bank                                                                                                                                                2

 

  1. Using a topical estrogen cream along with the steroid
  2. Using petrolatum ointment to minimize drying

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 171: Ankle and Foot Pain Test Bank

Multiple Choice

 

 

  1. A patient has pain on the plantar aspect of the heel with weight bearing after rest. The pain is worsened with dorsiflexion of the foot. What is the initial treatment for this patient?

 

  1. A series of steroid injections
  2. Avoiding all high-impact activities
  3. Night splints
  4. Wearing flat shoes only

 

 

 

  1. A patient injures an ankle while playing soccer and reports rolling the foot inward while falling with immediate pain and swelling of the lateral part of the joint. The patient is able to bear weight and denies hearing an audible sound at the time of injury. What does this history indicate?

 

  1. Likely ankle sprain with a possible fracture
  2. Mild ankle injury without fracture
  3. Mild soft tissue injury only
  4. Serious ankle injury with certain fracture

 

 

  1. A patient who is a distance runner reports pain in one heel that is worse in the morning and seems to improve with exercise. The provider notes localized swelling and a bony prominence at the heel. What is the initial treatment for this condition?

 

  1. Cessation of all sports activities and exercise
  2. Crutches and partial weight bearing

 

Test Bank                                                                                                                                                2

 

  1. Physical therapy for ultrasound therapy
  2. Referral to an orthopedist for MRI and evaluation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 172: Bone Tumors Test Bank

Multiple Choice

 

 

  1. Which treatments may be used to manage bone pain in patients with bone tumors? Select all that

 

  1. Bisphosphonates
  2. Exercise
  3. External beam radiation
  4. Massage
  5. Vertebralplasty

 

 

 

  1. A patient reports persistent lower back pain and constipation. A digital rectal examination reveals a mass at the sacrum. What will the primary care provider do to manage this patient?

 

  1. Order spinal radiographs in 3 months
  2. Perform an MRI of the sacrum
  3. Refer the patient to an oncologist
  4. Schedule the patient for a biopsy

 

 

 

  1. A provider discovers a bone tumor as an incidental finding on a radiograph in a patient who has sustained an injury to a ligament. The patient has not had pain prior to the injury. What will the provider do next?

 

  1. Consult with an orthopedic specialist

 

Test Bank                                                                                                                                                2

 

  1. Order a chest CT and full body scan
  2. Refer the patient to for a bone biopsy
  3. Repeat the radiograph in 6 to 12 months

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 173: Bursitis Test Bank

Multiple Choice

 

 

  1. A patient with shoulder pain is seen by an orthopedic specialist who notes erythema, warmth, and fluctuance of the shoulder joint. What is the next step in treatment for this patient?

 

  1. Admit to the hospital for intravenous antibiotics
  2. Inject lidocaine into the joint and reassess in 5 to 10 minutes
  3. Order a plain radiograph of the shoulder to identify possible fracture
  4. Perform a shoulder ultrasound to further evaluate the cause

 

 

 

  1. A patient with elbow pain without localized erythema or warmth is diagnosed with bursitis of the elbow and serum laboratory results are pending. What is the initial treatment while waiting for these results?

 

  1. Aspiration of the bursal sac for culture
  2. Corticosteroid injection into the bursal sac
  3. Elbow pads, NSAIDs, rest, and ice
  4. Physical and occupational therapy

 

 

 

  1. What are included in the initial management of bursitis of the heel? Select all that

 

  1. Activity modification and bracing

 

Test Bank                                                                                                                                                2

 

  1. Closed heel shoes to prevent further injury
  2. Corticosteroid injections
  3. Nonsteroidal anti-inflammatory medications
  4. Rest, ice, compression, and elevation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 174: Elbow Pain Test Bank

Multiple Choice

 

 

  1. A patient has chronic elbow pain associated with arthritis. What is included in management of this condition?

Select all that apply.

 

  1. Avoidance of certain activities
  2. Balanced rest and exercise
  3. Long-term NSAIDs
  4. Occupational therapy
  5. Splinting of the elbow

 

 

 

  1. A patient reports elbow pain and the examiner elicits pain with resisted wrist flexion, forearm pronation, and passive wrist extension on the affected side. What is a likely cause of this pain?

 

  1. Lateral epicondylitis
  2. Medial collateral ligament instability
  3. Medial epicondylitis
  4. Ulnar neuritis

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 175: Fibromyalgia and Myofascial Pain Syndrome Test Bank

Multiple Choice

 

 

  1. When counseling a patient about the long-term effects of fibromyalgia syndrome, what is important to include in teaching?

 

  1. A multidisciplinary approach to treatment is most
  2. Eventual damage to muscles and joints will
  3. Exercise may cause discomfort and damage to
  4. Medications are useful for controlling and preventing

 

 

 

  1. Which are symptoms associated with fibromyalgia? Select all that

 

  1. Gastrointestinal complaints
  2. Hepatosplenomegaly
  3. Musculoskeletal pain
  4. Non-restorative sleep
  5. Renal complications

 

 

  1. Which cause is implicated in patients with fibromyalgia syndrome (FMS)?

 

  1. Autoimmune disease
  2. Central nervous system dysfunction
  3. Muscle dysfunction
  4. Viral disease

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 176: Gout Test Bank Multiple Choice

 

  1. A patient with gout and impaired renal function who uses urate-lowering therapy (ULT) is experiencing an acute gout flare involving one joint. What is the recommended treatment?

 

  1. Administration of intra-articular corticosteroid
  2. Discontinuing ULT while treating the flare
  3. Oral colchicine for 5 days
  4. Therapy with NSAIDs begun within 24 hours

 

 

  1. A patient experiences a second gouty flare and the provider decides to begin urate-lowering therapy (ULT). How should this be prescribed?

 

  1. Begin with a high loading dose and gradually decrease
  2. Start ULT during the current flare for best results
  3. Start ULT in 5 weeks along with an anti-inflammatory drug
  4. ULT should be suspended during future gouty flares

 

  1. A post-menopausal female patient has a blood test that reveals hyperuricemia, although the patient has no symptoms of gout. What will the provider do?

 

  1. Ask the patient about medications and medical history
  2. Begin therapy with colchicine and an NSAID
  3. Recommend a low-purine, alcohol-restricted diet

 

Test Bank                                                                                                                                          2

  1. Treat for gout prophylactically to prevent a flare

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 177: Hand and Wrist Pain Test Bank

Multiple Choice

 

 

  1. A patient has pain at the base of one thumb and reports frequently dropping things because of pain and weakness in that joint. During physical examination, what will the examiner do to help diagnose this condition?

 

  1. Adduct the first metacarpal and hyperextend the metacarpal phalanx
  2. Flex the thumb while placing a finger on the metacarpophalangeal joint
  3. Passively extend the thumb and observe for puckering of the skin
  4. Place the thumb on the palm while deviating the hand toward the ulna

 

 

 

  1. A patient has symptoms of carpal tunnel syndrome. Which diagnostic tests will help confirm this disorder?

Select all that apply.

 

  1. Anti-nuclear antibody
  2. Electromyography
  3. Erythrocyte sedimentation rate
  4. Nerve conduction studies
  5. Plain radiographs

 

 

  1. A 40-year-old woman reports pain at the thumb base in one hand radiating to the distal radius. The provider learns that the woman knits for a hobby and is able to elicit the pain by asking the patient to pour water from a pitcher. Which condition is suspected in this patient?

 

  1. Carpal tunnel syndrome
  2. Palmar fibrosis
  3. Tenosynovitis
  4. Trigger finger

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 178: Hip Pain Test Bank

Multiple Choice

 

 

  1. A patient with chronic hip pain cannot take NSAIDs and tells the provider that acetaminophen is minimally helpful. What might the provider recommend initially to improve pain relief?

 

  1. A fentanyl patch
  2. Capsaicin
  3. Glucosamine
  4. Lidocaine patches

 

 

 

  1. An adult patient who has been taking high-dose corticosteroids reports a dull, aching pain in the groin and presents with a limp. What condition does the provider suspect, based on this history?

 

  1. Avascular necrosis of the femoral head
  2. Infectious arthritis of the hip
  3. Osteoarthritis of the hip
  4. Slipped capital femoral epiphysis

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 179: Infectious Arthritis Test Bank

Multiple Choice

 

 

  1. A patient reports the sudden onset of pain, redness, and swelling in one knee joint along with a no fever. The provider elicits exquisite pain with manipulation of the joint and notes no decrease in pain when the joint is at rest. Which is the likely cause of this arthritis?

 

  1. Bacterial infection
  2. Gout
  3. Lyme disease
  4. Rheumatoid arthritis

 

 

  1. An adolescent patient reports pain and swelling in various joints on the right side that comes and goes and occurs in the knee, elbow, wrist, and ankle. A physical examination reveals tenosynovitis and a maculopapular rash. Which diagnostic tests will be most helpful in determining a diagnosis in this patient?

 

  1. Blood cultures and a complete blood count
  2. Cultures of the urethra, pharynx, cervix, and rectum
  3. Skin lesion scrapings and cultures
  4. Urine cultures and renal function studies

 

 

  1. A patient has marked swelling of a shoulder joint with erythema and severe pain. The provider suspects a bacterial cause. Which culture will be most helpful to determine the cause of these symptoms?

 

  1. Blood culture

 

Test Bank                                                                                                                                                2

 

  1. Synovial fluid culture
  2. Urethral culture
  3. Urine culture

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 180: Knee Pain Test Bank

Multiple Choice

 

 

  1. Which maneuver during a physical examination is used to assess the anterior cruciate ligament?

 

  1. Anterior drawer test
  2. Posterior drawer test
  3. Valgus stress on knee joint
  4. Varus stress on knee joint

 

 

 

  1. A previously healthy patient reports a sensation of one knee locking or feeling like it will give way when descending stairs. The patient has no recollection of injury to the knee and denies pain. What is the most likely treatment for this disorder?

 

  1. Conservative management with RICE and activity modification
  2. Immediate referral to an orthopedic surgeon for possible repair
  3. Intra-articular injections of corticosteroids three times yearly
  4. Restricting participation in sports and strenuous workouts indefinitely

 

 

 

  1. A high school soccer player sustains a knee injury when kicked on the lateral side of the knee by another player. The provider notes significant swelling of the knee, with pain at the joint line on the medial aspect of the knee. What will the provider do to treat this injury?

 

Test Bank                                                                                                                                                2

 

  1. Instruct about RICE management and follow up in 1 week
  2. Refer for a same-day orthopedic consultation
  3. Schedule a magnetic resonance imaging (MRI) exam
  4. Splint the knee and refer for orthopedic consultation in 1 to 2 weeks

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 181: Low Back Pain Test Bank

Multiple Choice

 

 

  1. A patient has recurrent lumbar pain which is sometimes severe. The patient reports that prescription NSAIDs are no longer effective for pain relief. What will the provider recommend?

 

  1. Adjunctive treatment with physical therapy
  2. Beginning treatment with opioid analgesics
  3. Complementary and alternative therapies
  4. Referral to an interventional spine physician

 

 

  1. A patient reports severe back pain located in the lumbar spine. To evaluate whether the patient has axial pain or radicular pain, which assessment is necessary?

 

  1. Asking the patient to perform the Valsalva maneuver
  2. Assessing reflexes and asking about tingling or numbness
  3. Determining whether the pain is present with prolonged sitting
  4. Noting whether pain is mitigated with frequent position shifts

 

 

 

  1. A patient has an acute onset of lower back pain associated with lifting heavy objects at work. A physical examination reveals no loss of lower extremity function or neurological symptoms. What is the initial intervention for this patient?

 

  1. MRI to evaluate soft tissue involvement
  2. Plain radiographs to evaluate the extent of the injury
  3. Traction therapy to minimize complications

 

Test Bank                                                                                                                                                2

  1. Treatment with a nonsteroidal anti-inflammatory drug

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 182: Metabolic Bone Disease: Osteoporosis and Paget’s Disease of the Bone Test Bank

Multiple Choice

 

 

  1. A patient is diagnosed with osteoporosis. What is the recommended treatment once the diagnosis is made?

 

  1. Biphosphonate therapy
  2. Calcium and vitamin D
  3. Estrogen replacement
  4. Yoga and weight-bearing exercises

 

 

 

  1. A patient has bone pain and laboratory testing reveals an elevated serum alkaline phosphatase (SAP). Which test can help distinguish Paget’s from malignant bone disease?

 

  1. Bone densitometry
  2. Bone marrow biopsy
  3. Bone radiograph
  4. Bone scan

 

 

  1. The primary care provider is assessing a 45-year-old postmenopausal woman who has a family history of osteoporosis. Which test will be most useful to screen for this disease in this patient?

 

  1. Biochemical markers of bone resorption and bone formation
  2. Bone densitometry of the hip and posteroanterior lumbar spine
  3. Plain radiographs of the hips and lumbar and thoracic spine
  4. Serum calcium and serum 25-hydroxyvitamin D

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 183: Neck Pain Test Bank

Multiple Choice

 

 

  1. A patient comes to a provider with reports of unilateral arm pain and weakness with mild neck pain. The provider notes that the patient prefers holding the affected arm crossed in front of the throat. A history reveals a recent onset of sexual dysfunction. What does the provider suspect based on this history?

 

  1. Axial neck pain
  2. Cervical myelopathy
  3. Diabetic neuropathy
  4. Facet joint pain

 

 

 

  1. A patient has chronic radicular neck pain that no longer responds to over-the-counter NSAIDs and physical therapy measures and reports having difficulty sleeping. Which medication will the provider order?

 

  1. A skeletal muscle relaxant
  2. A tricyclic antidepressant
  3. An opioid analgesic
  4. Gabapentin

 

 

 

  1. A provider suspects degenerative disk disease in a patient with chronic neck pain. Which diagnostic test will be performed?

 

Test Bank                                                                                                                                                2

 

 

  1. Computerized tomography
  2. Magnetic resonance imaging
  3. Plain radiograph
  4. Radionucleotide bone scintigraphy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 184: Osteoarthritis Test Bank

Multiple Choice

 

 

  1. A 45-year-old patient has mild osteoarthritis in both knees and asks about non-pharmacologic therapies. What will the provider recommend?

 

  1. Aerobic exercise
  2. Glucosamine with chondroitin
  3. Therapeutic magnets or copper bracelets
  4. Using a cane or walker

 

 

 

  1. A patient who has osteoarthritis in the carpometacarpal joints of both thumbs asks about corticosteroid injections to treat symptoms. What will the provider tell this patient about this therapy?

 

  1. Corticosteroid therapy reduces inflammation and improves joint mobility
  2. Injections may be administered as needed up to 6 times per year
  3. Intra-articular injections provide significant pain relief for 3 to 4 months
  4. This treatment may cause a temporary increase in pain, warmth, and redness

 

 

 

  1. A 50-year-old woman reports pain in one knee upon awakening each morning that goes away later in the morning. A knee radiograph is negative for pathology and serum inflammatory markers are normal. What will the provider tell this patient?

 

Test Bank                                                                                                                                                2

 

  1. A magnetic resonance imaging study is necessary for diagnosis
  2. That the lack of findings indicates no disease process
  3. To take acetaminophen 1 gram three times daily for pain
  4. To use a cyclooxygenase 2-selective NSAIDs to reduce inflammation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 185: Osteomyelitis Test Bank

Multiple Choice

 

 

  1. A 3-year-old child has marked pain in one leg localized to the upper tibia with refusal to bear weight. The child has a high fever and a toxic appearance. Which type of osteomyelitis is most likely?

 

  1. Chronic osteomyelitis
  2. Hematogenous osteomyelitis
  3. Osteomyelitis from a contiguous focus
  4. Peripheral vascular disease osteomyelitis

 

 

 

  1. A 50-year-old patient with diabetes mellitus has a low-grade fever and pain on one foot. The provider notes erythema and swelling at the site along with several superficial skin ulcers without necrosis and suspects osteomyelitis. Which type of diagnostic study will the provider order?

 

  1. Biopsy of bone or debridement cultures
  2. Blood cultures and serologic markers of inflammation
  3. Magnetic resonance imaging of the foot
  4. Plain radiograph of the foot

 

 

  1. A patient has osteomyelitis related to vascular insufficiency. Which initial consultation is necessary?

 

Test Bank                                                                                                                                                2

 

 

  1. Infectious disease consultation
  2. Neurosurgical consultation
  3. Surgical consultation
  4. Wound care specialist consultation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 186: Shoulder Pain Test Bank

Multiple Choice

 

 

  1. A 45-year-old patient reports a recent onset of unilateral shoulder pain which is described as diffuse and is associated with weakness of the shoulder but no loss of passive range of motion. What does the provider suspect as the cause of these symptoms?

 

  1. Acromioclavicular joint disease
  2. Cervical radicular pain
  3. Glenohumeral arthritis
  4. Rotator cuff injury

 

 

 

  1. A patient reports a deep ache in one shoulder and the provider suspects tendonitis secondary to repetitive activity. To determine whether the pain is caused by impingement on the acromion, the provider will ask the patient to

 

  1. abduct the
  2. adduct the
  3. internally rotate the
  4. shrug the

 

 

 

  1. An examiner is evaluating a patient who reports unilateral shoulder pain and notes limited active and passive range of motion in the affected shoulder along with erythema and bulging on the anterior shoulder. What diagnosis is likely with this presentation?

 

  1. Acromioclavicular joint disease

 

Test Bank                                                                                                                                                2

 

  1. Adhesive capsulitis
  2. Inflammatory bursitis
  3. Rotator cuff tear

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 187: Sprains, Strains, and Fractures Test Bank

Multiple Choice

 

 

  1. An emergency department provider is giving instructions for rest, ice, compression, and elevation (RICE) treatment in a patient with a sprain. What is included in teaching about this home care?

Select all that apply.

 

  1. An elastic bandage is sufficient for compression
  2. Apply ice packs for 20 minutes three times daily
  3. Proximal joints should be elevated higher than distal joints
  4. Moist heat therapy may be applied if muscle spasm occurs
  5. Place a cloth between the ice pack and the skin

 

 

 

  1. A soccer player is brought to the emergency department after twisting an ankle during a game. An examination of the affected joint reveals ecchymosis and edema of the ankle and limited joint laxity along with pain on weight-bearing, although movement with pain is intact. Which grade sprain is likely?

 

  1. Grade I
  2. Grade II
  3. Grade III
  4. Grade IV

 

 

 

  1. A school-age child falls off a swing and fractures the humerus close to the elbow joint. What is the most important assessment for this patient to evaluate possible complications of this injury?

 

  1. Evaluation of pain with extension
  2. Palpation for joint laxity
  3. Salter-Harris classification
  4. The presence of a spiral fracture

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 188: Neuropsychological Evaluation Test Bank

Multiple Choice

 

 

  1. What are some common goals of neuropsychiatric evaluation? Select all that

 

  1. To definitively diagnose neurobehavioral disorders
  2. To determine the need for neurosurgical procedures
  3. To evaluate cognition when neuro-diagnostic tests are normal
  4. To help identify rehabilitation goals in brain-injured patients
  5. To monitor changes in symptoms over time

 

 

 

  1. What is    an   important   purpose   of    conducting    an   interview    prior    to    beginning neuropsychological testing on an older adult suspected of having dementia?

 

  1. To assess the patient’s ability to cooperate with the testing
  2. To determine the patient’s degree of dementia
  3. To evaluate the patient’s feelings about family members’ concerns
  4. To find out whether a referral to a specialist is needed

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 189: Amyotrophic Lateral Sclerosis Test Bank

Multiple Choice

 

 

  1. A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to have symptoms that include asymmetric weakness in the arms and difficulty walking. The neurologist recognizes these symptoms as characteristic of involvement of which portion of the nervous system?

 

  1. Lower motor neurons
  2. Upper motor neurons
  3. Corticospinal tracts
  4. Corticobulbar tracts

 

 

 

  1. The spouse of a patient newly-diagnosed with amyotrophic lateral sclerosis (ALS) asks about long-term care. What will the provider include when teaching the family about this disease?

 

  1. Bowel and bladder function will eventually be
  2. Positive-pressure ventilation can prolong
  3. Preventing malnutrition is a key element in
  4. The nerves affecting sensation will die

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 190: Bell’s Palsy Test Bank

Multiple Choice

 

 

  1. Which symptoms may occur with Bell’s palsy? Select all that

 

  1. Alteration in taste
  2. Decreased hearing
  3. Drooling
  4. Inability to open the eye
  5. Tinnitus

 

 

 

  1. A 35-year-old patient reports suddenly experiencing an asymmetric smile along with drooping and tearing in one eye. The patient has a history of a recent viral illness, but is otherwise healthy. During the exam, the provider notes that there is unilateral full face paralysis on the right side. What is the initial intervention for this patient?

 

  1. Perform confirmatory diagnostic tests
  2. Prescribe oral prednisolone
  3. Recommend wearing an eye patch
  4. Refer the patient to a neurologist

 

 

 

  1. What is recommended to prevent ophthalmic complications in patients with Bell’s palsy?

 

  1. Acupuncture
  2. Lubricating eye drops
  3. Patching of the eye

 

Test Bank                                                                                                                                                2

  1. Sunglasses

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 191: Cerebrovascular Events Test Bank

Multiple Choice

 

 

  1. A previously healthy 30-year-old patient is brought to the emergency department with signs of stroke. Diagnostic testing determines an ongoing ischemic cause. The patient’s spouse reports that symptoms began approximately 2 hours prior to transport. What is the recommended treatment?

 

  1. Administration of low-molecular-weight heparin
  2. Neurosurgical consultation for possible surgery
  3. Observation for complications prior to initiating tPA
  4. Tissue plasminogen activator (tPA) administration

 

 

  1. An elderly patient is brought to the emergency department after being found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient’s blood pressure is 220/190 mm Hg. What is the likely treatment for this patient?

 

  1. Carotid endarterectomy
  2. Close observation until symptoms resolve
  3. Neurosurgical consultation
  4. Thrombolytic therapy

 

 

 

  1. A patient exhibits visual field defect, ataxia, and dysarthria and complains of a mild headache. A family member reports that the symptoms began several hours An

 

Test Bank                                                                                                                                                2

 

examination reveals normal range of motion of the neck. What type of cerebrovascular event is most likely?

 

  1. Hemorrhagic stroke
  2. Hypertensive intracerebral hemorrhage
  3. Ischemic stroke
  4. Transient ischemic attack

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 192: Delirium Test Bank

Multiple Choice

 

 

  1. What are initial approaches when managing delirium in a hospitalized patient who is agitated and confused?

Select all that apply.

 

  1. Administer medications for sleep
  2. Apply physical restraints
  3. Attend to hydration and toileting needs
  4. Decrease stimulation
  5. Discontinue any non-essential medications

 

 

 

  1. A previously lucid patient with early-stage Alzheimer’s disease is hospitalized after a surgical procedure and exhibits distractibility and perceptual disturbances that occur only in the late afternoon. The patient has difficulty sleeping at night and instead sleeps much of the morning. What is the likely cause of these symptoms?

 

  1. Hyperactive delirium
  2. Hypoactive delirium
  3. Sundowner syndrome
  4. Worsening dementia

 

 

Test Bank                                                                                                                                                2

 

  1. An 80-year-old patient becomes apathetic, with decreased alertness and a slowing of speech several days after hip replacement surgery alternating with long periods of lucidity. What is the most likely cause of these symptoms?

 

  1. Anesthesia effects
  2. Delirium
  3. Pain medications
  4. Stroke

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 193: Dementia Test Bank

Multiple Choice

 

 

  1. A patient with dementia experiences agitation and visual hallucinations and is given haloperidol with a subsequent worsening of symptoms. Based on this response, what is the likely cause of this patient’s symptoms?

 

  1. Alzheimer’s disease
  2. Lewy body dementia
  3. Pseudodementia
  4. Vascular neurocognitive disorder

 

 

 

  1. A patient with Alzheimer’s disease (AD) is taking donepezil to treat cognitive symptoms. The patient’s son reports noting increased social withdrawal and sleep impairment. What is the initial step to manage these symptoms?

 

  1. Encourage activity and exercise
  2. Prescribe a selective serotonin reuptake inhibitor
  3. Recommend risperidone
  4. Referral to a neurologist for evaluation

 

 

  1. An elderly patient has symptoms of depression and the patient’s daughter asks about possible Alzheimer’s disease since there is a family history of this disease. A screening evaluation shows no memory loss. What is the initial step in managing this patient?

 

  1. Order brain imaging studies such as CT or MRI
  2. Perform genetic testing to identify true risk

 

Test Bank                                                                                                                                                2

 

  1. Prescribe a trial of an antidepressant medication
  2. Recommend a trial of a cholinesterase inhibitor drug

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 194: Dizziness and Vertigo Test Bank

Multiple Choice

 

 

  1. A patient reports a recurrent sensation of spinning associated with nausea and vomiting. Which test will the provider order to confirm a diagnosis for this patient?

 

  1. Electroencephalogram
  2. Holter monitoring and electrocardiogram
  3. Neuroimaging with computerized tomography
  4. The Hallpike-Dix positioning maneuver

 

 

 

  1. An elderly patient reports sensations of being off balance when walking, but does not experience dizziness. The provider will refer this patient to which specialist for further evaluation?

 

  1. Audiologist
  2. Cardiologist
  3. Neurologist
  4. Otolaryngologist

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 195: Guillain-Barré Syndrome Test Bank

Multiple Choice

 

 

  1. Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is developing muscle weakness and paresthesias?

 

  1. Lumbar puncture
  2. MRI imaging
  3. Nerve conduction studies
  4. Screening for systemic infection

 

 

 

  1. Which monitoring parameters are necessary when caring for a patient with Guillain-Barre syndrome?

Select all that apply.

 

  1. Bladder scans
  2. Cardiac telemetry
  3. Imaging studies
  4. Fever
  5. Vital capacity measures

 

 

 

  1. Following an upper respiratory infection, a patient begins to develop ataxia and distal paresthesias, along with oculomotor symptoms and double vision. Based on these presenting symptoms which type of GBS does this patient have?

 

  1. Acute inflammatory demyelinating polyradiculoneuropathy (AIDP)

 

Test Bank                                                                                                                                                2

 

  1. Acute motor axonal neuropathy (AMAN)
  2. Classic Guillain-Barre syndrome
  3. Miller Fisher syndrome (MFS)

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 196: Headache Test Bank

Multiple Choice

 

 

  1. A patient has recurrent cluster headaches and asks about abortive therapy. Which therapy is effective for a majority of patients with cluster headaches?

 

  1. Lithium
  2. NSAIDs
  3. Oxygen
  4. Verapamil

 

 

 

  1. A patient reports recurrent headaches occurring 1 or 2 times per month that generally occur with weather changes or when sleep patterns are disrupted and describes them as severe, with throbbing on one side of the head and sometimes accompanied by nausea. What is the recommended treatment for this type of headache?

 

  1. Gabapentin
  2. Propranolol
  3. Rizatriptan
  4. Topiramate

 

 

  1. Which medications may be useful in treating tension-type headache? Select all that

 

  1. Antiemetics
  2. Lithium
  3. Muscle relaxants

 

Test Bank                                                                                                                                                2

 

  1. NSAIDs
  2. Oxygen

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 197: Infections of the Central Nervous System Test Bank

Multiple Choice

 

 

  1. A provider suspects that a patient has bacterial meningitis. When should antibiotics be given?

 

  1. If the serum C-reactive protein is greater than 10 mg/L
  2. Immediately after blood and spinal cultures are obtained
  3. Prior to obtaining a CT scan or lumbar puncture
  4. When initial spinal fluid gram stain results are available

 

 

 

  1. A patient is brought to the emergency department with fever, lethargy, and headache without meningeal signs. The examination reveals hypotension and lethargy and the examiner notes petechiae on the patient’s trunk. What do these findings indicate?

 

  1. A poor prognosis
  2. Encephalitis
  3. Increased intracranial pressure
  4. Probable viral infection

 

 

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 198: Movement Disorders and Essential Tremor Test Bank

Multiple Choice

 

 

  1. Which are common hyperkinetic movement disorders? Select all that

 

  1. Dystonia
  2. Essential tremor
  3. Parkinson’s disease
  4. Progressive supranuclear palsy
  5. Tourette’s syndrome

 

 

 

  1. A patient reports trembling of both hands causing difficulty performing tasks with the hands. The provider notes symmetric, rhythmic movements which are present at rest and no other neurological findings. A history reveals that the trembling decreases when the patient has a glass of wine with dinner. What is the initial action?

 

  1. Evaluation in an emergency department
  2. Prescribing a beta blocker medication
  3. Reassurance that these will subside
  4. Referral to a neurologist

 

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 199: Multiple Sclerosis Test Bank

Multiple Choice

 

 

  1. A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2 days each about 2 months apart. Which diagnostic testing will the provider order initially?

 

  1. Lumbar puncture
  2. Magnetic resonance imaging
  3. Optical Coherence Tomography
  4. Visual evoked potential

 

 

 

  1. A patient diagnosed with multiple sclerosis and begins disease modulating therapy drugs. As part of the counseling about this therapy, the provider will tell the patient that this regimen will

 

  1. decrease the need for other
  2. induce long-term
  3. reduce the exacerbation
  4. stop progression of the

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 200: Parkinson’s Disease Test Bank

Multiple Choice

 

 

  1. A patient with Parkinson’s disease (PD) has been taking carbidopa-levodopa (Sinemet) with good results, but develops increased dyskinesia. Which drug will be added to this patient’s regimen to help control this symptom?

 

  1. Amantadine
  2. Benztropine
  3. Ropinirole
  4. Tolcapone

 

 

 

  1. A primary care provider suspects Parkinson’s disease (PD) in a patient. Which tests may be performed to diagnose this disorder?

 

  1. Neuroimaging to identify specific midbrain lesion
  2. Neuromuscular studies to identify reflex function
  3. Presence of 2 cardinal signs which improve with levodopa
  4. Serum creatine phosphokinase levels

 

 

 

  1. What are common symptoms seen in patients with Parkinson’s disease? Select all that

 

Test Bank                                                                                                                                                2

 

  1. Bradykinesia
  2. Festination
  3. Hyperphonia
  4. Rigidity
  5. Symmetric tremor

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 201: Seizure Disorder Test Bank

Multiple Choice

 

 

  1. A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency department with a seizure which has persisted for15 minutes and which immediately followed another 15 minute seizure. What is the priority action for this patient?

 

  1. Administer a dose of levetiracetam now and repeat in 10 minutes
  2. Administer lorazepam and monitor cardiorespiratory status
  3. Administer phenytoin and phenobarbital along with oxygen
  4. Admit the patient to the hospital for a diagnostic work up

 

 

  1. A patient with a seizure disorder has seizures which begin with eye twitching and occasionally visual hallucinations. Which site in the brain is the seizure focus?

 

  1. Frontal
  2. Occipital
  3. Parietal
  4. Temporal

 

 

 

  1. Which drug is used to treat patients with focal epilepsy and complex partial seizures?

 

  1. Carbamazepine
  2. Ethosuximide
  3. Lamotrigine
  4. Topiramate

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 202: Trigeminal Neuralgia Test Bank

Multiple Choice

 

 

  1. A patient reports paroxysms of burning, shock-like pain on both sides of the face usually triggered by chewing or talking. The provider suspects trigeminal neuralgia. Based on these presenting symptoms, what testing is indicated?

 

  1. Autoimmune laboratory panel
  2. Inflammatory markers
  3. Magnetic resonance imaging
  4. Plain radiographs

 

 

 

  1. A patient with trigeminal neuralgia has tried several medication regimens to control pain without success. What is the next step in management for this condition?

 

  1. Consultation with a psychiatrist
  2. Education about alternative treatments
  3. Recommending a pain center
  4. Referral to a neurosurgeon

 

 

  1. A patient is diagnosed with trigeminal neuralgia and reports having paroxysms several times each day. What is the initial treatment for this patient?

 

  1. A combination of baclofen, lamotrigine, and phenytoin
  2. A high dose of carbamazepine with subsequent titration downward
  3. Botox injections or intranasal lidocaine as needed
  4. Low doses of anticonvulsants with gradual increase as needed

 

Test Bank                                                                                                                                                2

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 203: Intracranial Tumors Test Bank

Multiple Choice

 

 

  1. A patient develops a gait disorder and the patient’s spouse reports noticing recent personality changes. The provider suspects a brain lesion. Which evaluation is especially important in the initial physical examination?

 

  1. Assessment of peripheral reflexes
  2. Evaluation of speech
  3. Examination of the optic fundi
  4. Testing for memory loss

 

 

 

  1. Which is the preferred treatment for primary brain tumors?

 

  1. Chemotherapy
  2. Palliative care
  3. Radiation therapy
  4. Surgical resection

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 204: Acromegaly Test Bank

Multiple Choice

 

 

  1. A patient has IGF-1 screening showing age- and gender-matched elevation and the provider orders a fasting oral glucose tolerance test (OGTT). The patient’s GH level drops to 1.1 ng/mL 120 minutes after the oral glucose is given. What will the provider conclude about these results?

 

  1. Acromegaly is certain
  2. Acromegaly is excluded
  3. Acromegaly is likely
  4. Acromegaly is possible

 

 

  1. A patient with sleep apnea is noted to have a large tongue and uvula along with deepening of the voice. What will the primary care provider do initially to evaluate these findings?

 

  1. Obtain an insulin-like growth factor-1 level
  2. Order a random serum growth hormone level
  3. Recommend an orthopedic consult for bone age evaluation
  4. Refer the patient to an otolaryngologist

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 205: Adrenal Gland Disorders Test Bank

Multiple Choice

 

 

  1. A patient has rapid weight gain, amenorrhea without pregnancy, and mild hypertension. Once confirmatory tests are performed, what is a possible treatment for this patient?

 

  1. Antihypertensive therapy
  2. Mineralocorticoid replacement
  3. Oral hydrocortisone
  4. Pituitary tumor resection

 

 

 

  1. A patient has new-onset hypertension with a systolic blood pressure of 180 mm Hg. Which test will the provider order to diagnose this patient?

 

  1. ACTH suppression testing
  2. Adrenal antibody tests
  3. Cortisol excretion studies
  4. Fractionated metanephrine levels

 

 

  1. A patient has unexplained weight loss and the provider notes increased skin pigmentation on light-exposed skin folds along with darkened palmar creases. Which laboratory tests will the provider order?

Select all that apply.

 

  1. Serum ACTH

 

Test Bank                                                                                                                                                2

 

  1. Serum cortisol
  2. Serum electrolytes
  3. TB skin testing
  4. Urine cortisol

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 206: Diabetes Mellitus Test Bank

Multiple Choice

 

 

  1. A patient who has diabetes has a blood pressure of 140/90 mm Hg and albuminuria. Which initial action by the primary care provider is indicated for management of this patient?

 

  1. Consulting with a nephrologist
  2. Limiting protein intake
  3. Prescribing an antihypertensive medication
  4. Referring to an ophthalmologist

 

 

 

  1. A patient who is obese has recurrent urinary tract infections and reports feeling tired most of the time. What initial diagnostic test will the provider order in the clinic at this visit?

 

  1. C-peptide level
  2. Hemoglobin A1C
  3. Random serum glucose
  4. Thyroid studies

 

 

 

  1. A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation. The provider notes that the patient appears confused and irritable and is sweating and shaking. What intervention will the provider expect to perform once the point of care blood glucose level is known?

 

Test Bank                                                                                                                                                2

 

  1. Dipstick urinalysis for ketones
  2. Giving a rapid-acting carbohydrate
  3. Injection of rapid-acting insulin
  4. Performing a hemoglobin A1C

 

 

 

  1. A patient with type 2 diabetes mellitus becomes insulin dependent after a year of therapy with oral diabetes medications. When explaining this change in therapy, the provider will tell the patient:

 

  1. it is necessary because the patient cannot comply with the previous
  2. that strict diet and exercise measures may be relaxed with insulin
  3. the use of insulin therapy may be
  4. this is because of the natural progression of the

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 207: Hirsutism Test Bank

Multiple Choice

 

 

  1. A young adult woman is unable to conceive after trying to get pregnant for over 6 months. The woman reports having had irregular periods since the onset of menarche. The provider notes that the woman is overweight, has acanthosis nigricans, and an excess hair distribution. What does the provider suspect as the most likely primary cause of these symptoms?

 

  1. Congenital adrenal hyperplasia
  2. Cushing’s syndrome
  3. Polycystic ovarian syndrome
  4. Type 2 diabetes

 

 

 

  1. A woman who has hirsutism with acne, and oligomenorrhea will most likely be treated with which medication to control these symptoms?

 

  1. Finasteride
  2. Levonorgestrel
  3. Norgestimate
  4. Spironolactone

 

 

  1. An obese adolescent female patient reports irregular periods and excessive acne. The provider notes an increased amount of hair on her upper back, shoulders, and upper What will the provider do, based on these findings?

 

  1. Consider treatment with oral contraceptive pills
  2. Counsel her about diet, exercise, and weight loss
  3. Recommend cosmetic laser hair removal

 

Test Bank                                                                                                                                                2

  1. Refer to an endocrinologist for evaluation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 208: Hypercalcemia and Hypocalcemia Test Bank

Multiple Choice

 

 

  1. A patient is in the emergency department with confusion and fatigue and a corrected serum calcium concentration is 10.8 mg/dL. What is the initial treatment for this patient prior to admission to the inpatient unit?

 

  1. Administration of furosemide
  2. Correction of potassium and magnesium levels
  3. Parenteral salmon calcitonin
  4. Rapid administration of intravenous normal saline

 

 

 

  1. A patient carpal spasm when a blood pressure cuff is inflated. Which diagnostic testing will the provider consider to evaluate the cause of this finding?

 

  1. Calcitriol level
  2. C-reactive protein
  3. Magnesium and vitamin D
  4. Protein electrophoresis

 

 

 

  1. A patient has low serum calcium associated with low serum albumin. What is the recommended treatment for this patient?

 

  1. Calcium supplementation only

 

Test Bank                                                                                                                                                2

 

  1. Correction of other serum electrolytes
  2. Thiazide diuretics and sodium restriction
  3. Vitamin D and calcium supplementation

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 209: Hyperkalemia and Hypokalemia Test Bank

Multiple Choice

 

 

  1. A patient with normal renal function has a potassium level of 6.0 mEq/L. Which underlying cause is possible in this patient?

 

  1. Adrenocortical deficiency
  2. Alcoholism
  3. Hypertension
  4. Malabsorption syndrome

 

 

 

  1. A hospitalized patient with renal failure is accidently given parenteral potassium and has a potassium level of 7.0 mEq/L. An ECG reveals a normal QRS interval. What is the initial recommended treatment for this patient?

 

  1. Calcium chloride
  2. Insulin and glucose infusion
  3. Sodium bicarbonate
  4. Sodium polystyrene sulfate

 

 

 

  1. A patient has a serum potassium level of 3 mEq/L and a normal blood pressure. Which test should be performed initially to assist with the differential diagnosis?

 

  1. Plasma aldosterone
  2. Plasma renin activity
  3. Serum bicarbonate

 

Test Bank                                                                                                                                                2

  1. Serum magnesium

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 210: Hypernatremia and Hyponatremia Test Bank

Multiple Choice

 

 

  1. A patient has euvolemic hyponatremia secondary to chronic syndrome of inappropriate antidiuretic hormone (SIADH) and is hospitalized for fluid replacement. When preparing to discharge the patient home, what will be included in teaching?

 

  1. Limiting dietary protein intake
  2. Limiting fluids to 500 mL/day for several days
  3. Restriction of sodium intake
  4. The importance of adherence to vaptan therapy

 

 

 

  1. An elderly patient who is taking a thiazide diuretic has been ill with nausea and vomiting and is brought to the emergency department for evaluation. An assessment reveals oliguria, hypotension, and tachycardia and serum sodium is 118 mEq/L. What is the treatment?

 

  1. A single infusion of hypertonic saline
  2. Addition of spironolactone
  3. Emergency volume repletion with 3%
  4. Fluid and dietary sodium restriction

 

 

 

  1. A high school athlete is brought to the emergency department after collapsing during outdoor practice on a hot day. The patient is weak, irritable, and confused. Serum sodium is 152 mEq/L and has dry mucous membranes and tachycardia. What is the initial approach to rehydration in this patient?

 

  1. Hypotonic intravenous fluid replacement

 

Test Bank                                                                                                                                                2

 

  1. Intravenous fluid resuscitation with an isotonic solution
  2. Loop diuretics and hypotonic intravenous fluids
  3. Oral water replacement

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 211: Lipid Disorders Test Bank

Multiple Choice

 

 

  1. A patient with type 2 diabetes has a low-density lipoprotein (LDL) level of 110 gm/dL. What is recommended to manage this patient?

 

  1. Dietary and lifestyle changes to modify risk
  2. Initial treatment with a low intensity statin medication
  3. Prescription of a moderate or high intensity statin
  4. Statin therapy until the LDL level is below 75 mg/dL

 

 

 

  1. When using the 2013 ACC/AHA “Guideline on the Assessment of Cardiovascular Risk” to treat patients with hyperlipidemia, the practitioner understands that it provides information about:

 

  1. goals for treatment for low-density lipoprotein
  2. how to titrate statin drugs to achieve goal
  3. use of non-statin therapy for primary
  4. which patients will benefit from statin

 

 

 

  1. A patient who is taking a statin drug to treat dyslipidemia has begun a diet and exercise program. The patient reports new onset of muscle pain several weeks after beginning therapy. What is the initial action by the provider?

 

  1. Discontinue the statin drug immediately

 

Test Bank                                                                                                                                                2

 

  1. Obtain a creatine kinase level
  2. Prescribe acetaminophen or ibuprofen
  3. Recommend reducing exercise intensity

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 212: Metabolic Syndrome Test Bank

Multiple Choice

 

 

  1. What is important about increased PAI-1 levels in patients with metabolic syndrome?

 

  1. They cause increased insulin
  2. They increase the risk of arterial
  3. They lower the risk of
  4. They predispose patients to

 

 

 

  1. Which medication given for patients with metabolic syndrome helps to lower PAI-1 levels?

 

  1. Aspirin
  2. Atorvastatin
  3. Metformin
  4. Niacin

 

 

  1. Which findings are part of the 2009 diagnostic criteria for metabolic syndrome? Select all that

 

  1. Decreased plasminogen activator inhibitor 1 levels
  2. Elevated waist circumference
  3. Fasting plasma glucose ≧100 mg/dL
  4. HDL cholesterol ≧45 mg/dL
  5. Triglycerides ≧150 mg/dL

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 213: Parathyroid Gland Disorders Test Bank

Multiple Choice

 

 

  1. A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for this patient?

 

  1. Annual monitoring of calcium, creatinine, and bone density
  2. Avoidance of weight-bearing exercises
  3. Decreasing calcium and vitamin D intake until values normal
  4. Parathyroidectomy

 

 

 

  1. Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis of primary hyperparathyroidism?

 

  1. Appropriately high PTH along with hypocalcemia
  2. Appropriately increased PTH and low or normal serum calcium
  3. Inappropriate secretion of PTH along with hypercalcemia
  4. Prolonged inappropriate secretion of PTH with subsequent hypercalcemia

 

 

 

  1. Which findings are symptoms of hyperparathyroidism? Select all that

 

Test Bank                                                                                                                                                2

 

  1. Chvostek’s sign
  2. Cognitive impairment
  3. Left ventricular hypertrophy
  4. Perioral paresthesias
  5. Renal calculi

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 214: Thyroid Disorders Test Bank

Multiple Choice

 

 

  1. Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism?

 

  1. 2 uIU/L
  2. 4 uIU/L
  3. 4 uIU/L
  4. 2 uIU/L

 

 

 

  1. A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the following laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A pregnancy test is negative. What is the initial treatment for this patient?

 

  1. Beta blocker medications
  2. Radioiodine therapy
  3. Surgical resection of the thyroid gland
  4. Thionamide therapy

 

 

 

  1. A postpartum woman develops fatigue, weight gain, and constipation. Laboratory values reveal elevated TSH and decreased T3 and T4 levels. What will the provider tell this patient?

 

  1. A thyroidectomy will be
  2. She should be referred to an
  3. She will need lifelong

 

Test Bank                                                                                                                                                2

 

  1. This condition may be

 

 

  1. A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules for potential malignancy, which test is performed?

 

  1. Radionucleotide imaging
  2. Serum calcitonin
  3. Serum TSH level
  4. Thyroid ultrasound

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 215: Ankylosing Spondylitis and Related Disorders Test Bank

Multiple Choice

 

 

  1. A patient is treated for a urinary tract infection and, 3 weeks later, presents with pain and swelling of one knee and in one hand, along with inflammation in both eyes. What will the provider suspect as the cause of these symptoms?

 

  1. Ankylosing spondylitis
  2. Infectious arthritis
  3. Psoriatic arthritis
  4. Reactive arthritis

 

 

 

  1. A patient is diagnosed with ankylosing spondylitis and begins taking a COX-2 inhibitor with minimal pain and inflammation relief. What will the provider order initially to manage this patient’s symptoms?

 

  1. A trial of sulfasalazine and methotrexate
  2. Biologic anti-tumor necrosis factor agents
  3. Changing to a COX-1 inhibitor medication
  4. Corticosteroid injections every three months

 

 

 

  1. A patient reports a history of recurrent lower back pain for 6 months. The patient describes the pain as a deep ache and stiffness that is worse upon awakening and improves after

 

Test Bank                                                                                                                                                2

 

walking. Which findings will the examiner elicit to help make a clinical diagnosis of ankylosing spondylitis?

Select all that apply.

 

  1. Assessment of the degree of lumbar lordosis
  2. Evaluation of lateral thoracic spine flexion
  3. Measurement of chest expansion
  4. Noting the degree of cervical kyphosis
  5. Observation for scapular asymmetry

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 216: Polymyalgia Rheumatica and Giant Cell Arteritis Test Bank

Multiple Choice

 

 

  1. A 60-year-old patient reports new onset of bilateral shoulder pain with morning stiffness lasting approximately one hour. Which will be included in initial diagnostic testing for this patient?

Select all that apply.

 

  1. Antinuclear antibodies
  2. ESR and CRP
  3. Liver function tests
  4. Protein electrophoresis
  5. Serum calcitonin

 

 

 

  1. A patient who is taking prednisolone 20 mg daily to treat polymyalgia rheumatica, reports blurred vision. What will the provider do?

 

  1. Discontinue the medication
  2. Increase the prednisolone dose to 60 mg daily
  3. Prescribe NSAIDs to treat the inflammation
  4. Refer to a rheumatologist immediately

 

 

  1. A patient is diagnosed with polymyalgia rheumatica with giant cell arteritis. Which dose of prednisolone will be given initially?

 

  1. 15 mg daily
  2. 20 mg daily
  3. 30 mg daily

 

Test Bank                                                                                                                                                2

  1. 60 mg daily

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 217: Raynaud’s Phenomenon Test Bank

Multiple Choice

 

 

  1. A provider performs a nail fold capillaroscopy on a patient who reports marked color changes of both hands with cold exposure and notes tortuous and dilated capillary loops. This finding is consistent with

 

  1. primary Raynaud’s
  2. secondary Raynaud’s

 

 

 

  1. A patient who has secondary Raynaud’s phenomena with severe digital ischemia. Which treatment is indicated for this patient?

 

  1. Ginkgo biloba
  2. Intravenous prostaglandin E1
  3. Oral nifedipine
  4. Sildenafil as needed

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 218: Rheumatoid Arthritis Test Bank

Multiple Choice

 

 

  1. Which are symptoms of rheumatoid arthritis that distinguish it from osteoarthritis? Select all that

 

  1. Extra-articular inflammatory signs
  2. History of injury to affected joints
  3. Morning stiffness of at least one hour
  4. Symmetric tender, swollen joints
  5. Unilateral joint involvement

 

 

 

  1. A patient is diagnosed with rheumatoid arthritis after a review of systems, confirmatory lab tests, and synovial fluid analysis. What will the provide order initially to treat this patient?

 

  1. Disease-modifying anti-rheumatic drugs
  2. Long-term glucocorticoid therapy
  3. Non-pharmacological treatments
  4. Nonsteroidal anti-inflammatory drugs

 

 

 

  1. A patient has swelling and tenderness in the small joints of both hands and reports several weeks of malaise and fatigue. A RF test is negative. What will the primary care provider do next?

 

  1. Begin treatment with a biologic disease-modifying anti-rheumatic drug

 

Test Bank                                                                                                                                                2

 

  1. Order radiographic tests, a CBC, and acute-phase reactant levels
  2. Reassure the patient that the likelihood of rheumatoid arthritis is low
  3. Refer the patient to an orthopedic specialist for evaluation and treatment

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 219: Systemic Lupus Erythematosus Test Bank

Multiple Choice

 

 

  1. A patient with systemic lupus erythematosus (SLE) has frequent symptoms and has been taking prednisone for each episode. The provider plans to start hydroxychloroquine and the patient asks why this medication is necessary. What will the provider tell this patient about this medication?

 

  1. It is effective in reducing disease flares and for tapering
  2. It is given in conjunction with steroids to improve
  3. It lowers blood pressure and decreases the risk for renal
  4. It prevents the need for biphosphenate

 

 

 

  1. A patient with systemic lupus erythematosus (SLE) develops end-stage renal disease. Because of the underlying SLE, what treatment is recommended for this patient?

 

  1. Dialysis only
  2. Immunosuppressant therapy
  3. Kidney transplantation
  4. Palliative care

 

 

 

  1. Which laboratory tests may help distinguish systemic lupus erythematosus (SLE) from other systemic rheumatologic disorders?

 

Test Bank                                                                                                                                                2

 

 

  1. Antinuclear antibody titer
  2. C-reactive protein
  3. Rheumatoid factor
  4. Serum complement levels

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 220: Vasculitis Test Bank

Multiple Choice

 

 

  1. Which is a distinctive finding in patients who have Churg-Strauss syndrome (CSS)?

 

  1. Elevated ESR and CRP
  2. HBV surface antigen
  3. Increased eosinophils
  4. Positive antinuclear antibodies

 

 

 

  1. A patient has a palpable purpural rash. This finding is most consistent with

 

  1. small-vessel
  2. medium-vessel
  3. large-vessel
  4. central-vessel

 

 

 

  1. A child has a high fever, bilateral conjunctivitis, and a desquamating rash and is presumed to have a vasculitic disease. What is the likely treatment for this child?

 

  1. Antibiotic therapy for 10 to 14 days
  2. Aspirin and intravenous immunoglobulin
  3. High-dose prednisolone therapy
  4. Immunosuppressant medications

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 221: Barotrauma and Other Diving Injuries Test Bank

Multiple Choice

 

 

  1. A scuba diver reports persistent nosebleeds after a diving trip. What is the treatment for this condition based on this history?

 

  1. A period of bedrest
  2. Decongestant medications
  3. Recompression therapy
  4. Referral to an otolaryngologist

 

 

 

  1. A patient is brought to an emergency department after a diving accident and is receiving inhaled 100% oxygen. This is given in order to

 

  1. enhance oxygen delivery to ischemic
  2. improve oxygen
  3. prevent the need for recompression
  4. reduce the risk of neurological

 

 

 

  1. When evaluating a person who is interested in taking a scuba diving class, the practitioner will screen for which conditions?

Select all that apply.

 

  1. Chronic sinusitis
  2. Diabetes mellitus
  3. Peptic ulcer disease

 

Test Bank                                                                                                                                                2

 

  1. Pressure equalizing ear tubes
  2. Recurrent urinary tract infections

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 222: Chronic Pain Test Bank

Multiple Choice

 

 

  1. A patient with chronic leg pain describes the pain as “stabbing” and “throbbing.” This is characteristic of which type of pain?

 

  1. Neuropathic pain
  2. Referred pain
  3. Somatic pain
  4. Visceral pain

 

 

 

  1. A patient is beginning treatment for chronic pain and is unable to tolerate nonsteroidal anti- inflammatory drugs. What will the provider prescribe for this patient?

 

  1. A mixed opiate product
  2. A pure opioid compound
  3. A referral for a nerve block procedure
  4. A selective serotonin reuptake inhibitor

 

 

 

  1. A patient who has chronic lower back pain reports increased difficulty sleeping unrelated to discomfort, along with a desire to quit working. What will the provider do?

 

  1. Ask the patient about addiction issues

 

Test Bank                                                                                                                                                2

 

  1. Consult with a social worker
  2. Increase the dosage of prescribed pain medications
  3. Order radiographic studies of the lower spine

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 223: Fatigue Test Bank

Multiple Choice

 

 

  1. A patient is seen in the clinic with complaints of constant fatigue. The patient’s spouse reports that the patient moves and kicks the legs frequently during sleep. What treatment will the provider anticipate once a diagnosis of the underlying cause is confirmed?

 

  1. An anti-oxidant diet
  2. Cognitive behavioral therapy
  3. Iron and vitamin C supplements
  4. Melatonin daily at bedtime

 

 

 

  1. Which are causes of physiologic fatigue? Select all that

 

  1. Acute and chronic illness
  2. Excessive alcohol use
  3. Irregular sleep habits
  4. Medication side effects
  5. Morbid obesity

 

 

 

  1. A patient with poorly controlled diabetes mellitus has chronic fatigue symptoms. What is the most likely underlying cause of this patient’s fatigue?

 

  1. Calorie depletion
  2. Decreased metabolism
  3. Psychological distress

 

Test Bank                                                                                                                                                2

  1. Sleep apnea

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 224: Fever Test Bank

Multiple Choice

 

 

  1. A patient has a fever of unknown etiology and blood tests reveal elevated eosinophils. The patient has no history of asthma or allergies. What may be the cause of this fever?

 

  1. Animal bite
  2. Endocarditis
  3. Lymphoma
  4. Parasites

 

 

 

  1. Which patients with fever should generally be treated with antipyretics? Select all that

 

  1. Children under the age of 5 years
  2. Patients taking antibiotics to treat infection
  3. Patients with temperature greater than 41° C
  4. Patients with urinary tract infection
  5. Those with underlying cardiovascular disease

 

 

 

  1. A patient reports daily, recurrent fever associated with sweating, chills, and facial flushing, along with recent weight loss. What may this type of fever indicate?

 

  1. An underlying disease caused by animal bites
  2. Fever related to an immunocompromised state
  3. Possible exposure to tropical diseases
  4. Tuberculosis or lymphoma

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 225: Immunodeficiency Test Bank

Multiple Choice

 

 

  1. A 6-month-old infant is suspected of having an immune deficiency disorder. Which diagnostic tests may be included to evaluate this patient?

Select all that apply.

 

  1. Blood, urine, sputum, and wound cultures
  2. Delayed-type hypersensitivity skin testing
  3. ESR and CRP
  4. Metabolic profiles
  5. Serum electrolytes

 

 

 

  1. A patient who has recurrent pneumococcal pneumonia and exhibits prolonged bleeding, easy bruising, and eczema. Which immunodeficiency disorder is likely in this patient?

 

  1. DiGeorge syndrome
  2. Hyperimmunoglobulinemia E syndrome
  3. Severe combined immunodeficiency disease (SCID)
  4. Wiskott-Aldrich syndrome (WAS)

 

 

 

  1. A child has a primary immunodeficiency and the parent asks the provider about vaccines. What will the provider tell this patient?

 

Test Bank                                                                                                                                                2

 

 

  1. Avoid all vaccines since immunizations can cause disease in this child
  2. Immunized with all recommended childhood vaccines to prevent serious disease
  3. Some vaccines are contraindicated in those with T-cell involvement only
  4. The child may need more vaccine boosters than other children

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 226: Lymphadenopathy Test Bank

Multiple Choice

 

 

  1. A child developed cervical lymphadenopathy after a scabies infestation. One node remains enlarged 6 months after the infestation, but has not increased in size. The physical examination reveals a non-tender, non-erythematous node. What will the provider tell the child’s parents?

 

  1. The child may need surgical
  2. The child should see a pediatric
  3. The node will need to be
  4. This node is most likely

 

 

 

  1. An adolescent patient comes to the primary care provider because of a swollen lymph node which is warm, tender, and rapidly enlarging. Which initial action will the provider take?

 

  1. Observe the node over a period of 3 to 4 weeks
  2. Obtain a complete blood count with differential
  3. Prescribe empiric antibiotics for 10 to 14 days
  4. Refer for an ultrasound and possible biopsy

 

 

 

  1. A 50-year-old patient presents with supraclavicular lymphadenopathy. Which action is correct?

 

  1. Consult with an oncologist for evaluation

 

Test Bank                                                                                                                                                2

 

  1. Perform testing for sexually transmitted infections
  2. Reassure the patient that this will resolve
  3. Treat empirically with an antibiotic

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 227: Sleep Disorders Test Bank

Multiple Choice

 

 

  1. A patient is diagnosed with mild restless leg syndrome which occasionally interferes with sleep. Which initial treatment will be helpful?

 

  1. A CPAP devices
  2. A dopaminergic agonist
  3. Hot baths and exercise
  4. Supplemental iron

 

 

 

  1. Which patient would benefit from a polysomnography evaluation to assess a potential sleep disorder?

 

  1. A child with enlarged tonsils who has daytime sleepiness
  2. A patient with GERD who has difficulty falling asleep
  3. A shift worker who has trouble adjusting to new schedules
  4. An elderly woman with osteoarthritis who has difficulty staying asleep

 

 

 

  1. A patient who has excessive daytime sleepiness tells the practitioner that he goes to bed and gets up at the same times each day but still wakes up tired. The spouse reports that the patient snores so much she has had to move to another bedroom. The patient is otherwise healthy and does not take any medications or drink alcohol. Which diagnostic test may be performed for this patient?

 

  1. Full overnight polysomnography (PSG)

 

Test Bank                                                                                                                                                2

 

  1. Multiple sleep latency test (MSLT)
  2. Overnight pulse oximetry
  3. Unattended out of center sleep testing (OCST)

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 228: Unintended Weight Loss Test Bank

Multiple Choice

 

 

  1. What factors may contribute to weight loss from functional anorexia in older women? Select all that

 

  1. Apathy
  2. Delayed gastric emptying
  3. Malabsorption
  4. Pain with elimination
  5. Urinary frequency

 

 

 

  1. Which non-pharmacologic intervention may be of most benefit in frail elders to restore physical function and improve appetite?

 

  1. Calorie dense foods
  2. Exercise
  3. Increased protein
  4. Nutritional drinks

 

 

  1. An elderly woman has marked decrease in muscle strength without weight loss. Which condition does the provider suspect in this patient?

 

  1. Cachexia
  2. Kwashiorkor
  3. Marasmus
  4. Sarcopenia

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 229: Emerging and Reemerging Infectious Diseases Test Bank

Multiple Choice

 

 

  1. Using molecular polymerase chain reaction (PCR) techniques, a hospitalist identifies the presence of human metapneumovirus in a child who has bronchiolitis. This disease is considered an emerging disease because

 

  1. it has become more
  2. it has lately been
  3. it is becoming
  4. it is only recently

 

 

 

  1. What are risk factors for the increase in emerging and re-emerging infectious diseases? Select all that

 

  1. Antibiotic use in animal feeds
  2. Counterfeit drug sales
  3. Decreased antibiotic use
  4. Exotic pet ownership
  5. Reforestation of farmlands

 

 

  1. A patient plans to travel to western Africa and is concerned about contracting Ebola. What will the provider suggest to this patient?

 

Test Bank                                                                                                                                                2

 

  1. Avoid contact with infectious body fluids
  2. Obtain the vaccine prior to travel
  3. Wear a mask when venturing outdoors
  4. Wear clothing that covers the skin

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 230: HIV Infection Test Bank

Multiple Choice

 

 

  1. A pregnant woman tests positive for HIV infection. What will the provider recommend?

 

  1. Consideration of termination of the pregnancy
  2. No treatment and caesarian section for delivery
  3. Treatment with highly active antiretroviral therapy
  4. Treatment with standard antiretroviral therapy

 

 

 

  1. A homeless patient who has HIV infection has been on antiretroviral therapy (ART) for 18 months and has had normal CD4 counts and viral loads for past year. What will the provider recommend?

 

  1. Allow for periods of time off from ART medications
  2. Begin monitoring viral load and CD4 counts every 6 to 12 months
  3. Consider beginning highly active antiretroviral therapy (HAART)
  4. Continue monitoring viral load and CD4 counts every 3 to 4 months

 

 

 

  1. Which patients with documented HIV infection may be classified has having acquired immunodeficiency syndrome (AIDS)?

Select all that apply.

 

Test Bank                                                                                                                                                2

 

  1. A patient with a CD4 cell count of 150/mm3
  2. A patient with a CD4 cell count of 400/mm3
  3. A patient with contact with a partner who has AIDS
  4. A patient with esophageal candidiasis
  5. A patient with tuberculosis

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 231: Influenza Test Bank

Multiple Choice

 

 

  1. A 65-year-old patient who has not had an influenza vaccine is exposed to influenza and comes to the clinic the following day with fever and watery, red eyes. What will the provider do initially?

 

  1. Administer LAIV influenza vaccine
  2. Begin treatment with an antiviral medication
  3. Observe for improvement or worsening for 24 hours
  4. Perform a nasal swab for RT-PCR assay

 

 

 

  1. The parent of a 4-month-old infant who has had an episode of bronchiolitis asks the provider if the infant may have an influenza vaccine. What will the provider tell this parent?

 

  1. The infant should be given prophylactic antiviral
  2. The infant should have an influenza vaccine now with a booster in 1
  3. The infant should have the live attenuated influenza vaccine (LAIV).
  4. The rest of the family and all close contacts should have the influenza

 

 

  1. A previously healthy patient develops influenza which is confirmed by RT-PCR testing and begins taking an antiviral medication. The next day, the patient reports increased fever and cough without respiratory distress. The patient’s lungs are clear and oxygen saturations are 97% on room air. What will the provider recommend?

 

  1. Admission to the hospital for treatment of complications
  2. Empiric antibiotics to treat a possible secondary infection
  3. Referral to a specialist for evaluation and treatment
  4. Symptomatic treatment with close follow up in clinic

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 232: Infectious Diarrhea Test Bank

Multiple Choice

 

 

  1. A patient has had mild acute diarrhea for 8 days. The patient is alert with normal vital signs and no abdominal discomfort, but appears mildly dehydrated. Which tests will the provider perform?

Select all that apply.

 

  1. BUN and creatinine
  2. Complete blood count
  3. Serum electrolytes
  4. Stool for fecal leukocytes
  5. Stool for occult blood

 

 

 

  1. A patient who has recently traveled has acute diarrhea which began the day after returning home. What are recommended treatments for this type of diarrhea?

Select all that apply.

 

  1. Ciprofloxacin for 3 days, twice daily
  2. Loperamide at bedtime and after each stool
  3. Oral fluid replacement
  4. Quinolones daily for 2 to 4 weeks
  5. Sulfamethoxazole twice daily for 5 days

 

 

 

  1. A patient is experiencing small-volume, non-inflammatory stools. Which organisms may be suspected in this case?

Select all that apply.

 

Test Bank                                                                                                                                                2

 

 

  1. Clostridium difficile
  2. Cryptosporidium
  3. Escherichia coli
  4. Giardia
  5. Shigella

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 233: Infectious Mononucleosis Test Bank

Multiple Choice

 

 

  1. A patient with EBV-IM also has group A beta-hemolytic streptococcal pharyngitis and is being treated with amoxicillin. On the third day of treatment, the patient develops a rash. A urinalysis is normal. What does this indicate?

 

  1. A reaction to the amoxicillin
  2. A streptococcal rash
  3. Hematologic complications
  4. Hemolytic-uremic syndrome

 

 

 

  1. An adolescent patient who plays football in high school is diagnosed with EBV infectious mononucleosis and is noted to have splenomegaly. What will the provider recommend to this patient about returning to sports?

 

  1. Abdominal ultrasounds are recommended to determine
  2. Corticosteroid therapy may help shorten the course of the
  3. He may return to minimal contact practice in 2 to 3
  4. It will be safe to play football in 3 to 4

 

 

 

  1. An adolescent patient has fever, pharyngitis, and cervical lymphadenopathy and has a negative group A beta-hemolytic throat culture. A complete blood count shows absolute lymphocytosis, but a heterophil antibody test is negative for Epstein-Barr virus (EBV). What will the provider tell the patient about the likelihood of infectious mononucleosis (IM)?

 

Test Bank                                                                                                                                                2

 

  1. It will be necessary to repeat the heterophil antibody test in a few
  2. Liver function tests will help to confirm a diagnosis of EBV-IM.
  3. The likelihood of EBV infectious mononucleosis is still
  4. This IM is most likely caused by a virus other than Epstein-Barr

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 234: Tick-Borne Illnesses Test Bank

Multiple Choice

 

 

  1. A patient presents with fever, severe headache, and rash and has a history of tick bite. Which tick-borne illness is suspected?

 

  1. Babesiosis
  2. Erlichiosis
  3. Lyme disease
  4. Rocky Mountain spotted fever

 

 

 

  1. A patient with mild symptoms of babesiosis is diagnosed with a positive PCR assay. What is the recommended treatment for this patient?

 

  1. Atovaquone and azithromycin for 7 to 10 days
  2. Clindamycin and quinine for 10 to 14 days
  3. Intravenous clindamycin and hospitalization
  4. Symptomatic therapy with observation

 

 

 

  1. A parent brings a child to clinic and reports pulling a tick off of the child after being outdoors that day. The parent is concerned that the child may have Lyme disease. What will the provider tell this parent?

 

  1. A laboratory test today will help identify the presence of the
  2. Antibiotic prophylaxis is necessary to prevent development of
  3. Transmission of the organism only occurs with prolonged attachment of the
  4. Unless the child develops systemic symptoms, treatment is not

 

Test Bank                                                                                                                                                2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 235: Tuberculosis Test Bank

Multiple Choice

 

 

  1. A 25-year-old patient has a tuberculosis skin test which reveals an area of induration of 12 mm. The patient is a recent immigrant from Mexico and lives in a homeless shelter. What is the recommended treatment for this patient?

 

  1. Administer the BCG vaccine
  2. Begin INH preventive therapy
  3. Order INH and Rifampin
  4. Perform regular TB skin testing every few months

 

 

 

  1. A provider is concerned that a young child may have latent tuberculosis infection (LTBI). Which test will be performed initially to screen for this infection?

 

  1. Chest radiograph
  2. Interferon gamma release assay
  3. Mantoux test
  4. Two-step TST

 

 

 

  1. A patient who has HIV infection has a negative tuberculosis skin test with induration less than 10 mm. The provider learns that the patient lives with a person who has active tuberculosis. What is the next step in managing this patient?

 

Test Bank                                                                                                                                                2

 

  1. Begin empiric antibiotic therapy
  2. Order a chest radiograph
  3. Perform an interferon gamma release assay
  4. Refer to an infectious disease specialist

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 236: West Nile Virus Test Bank

Multiple Choice

 

 

  1. A patient who reports traveling to an area where West Nile virus (WNV) is endemic presents with fever, arthralgia, and rash for the last 7 days. What initial testing is recommended to confirm a diagnosis of WNV?

 

  1. ELISA for CSF antibodies
  2. ELISA for serum IgM
  3. PCR assays of CSF
  4. PCR assays of serum

 

 

 

  1. A patient expresses concern about contracting West Nile virus (WNV) infection after a family member becomes ill with the disease. What will the provider tell this patient?

 

  1. Human hosts may become reservoirs for infection for
  2. Humans may transmit the virus to mosquitoes after a
  3. Humans must be bitten by a mosquito infected by a
  4. Human-to-human transmission is possible with this

 

 

 

 

 

 

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 237: Anemia Test Bank

Multiple Choice

 

 

  1. A 20 kg child has iron-deficiency anemia and will begin taking an oral iron preparation. What will the provider teach the child’s parents about administration of this medication?

 

  1. Iron supplements should be given with
  2. The child must take the iron for 3
  3. The correct dose is 30 mg twice
  4. The iron is stopped when the hemoglobin

 

 

 

  1. A 60-year-old female patient has recently lost weight and a physical examination reveals a beefy-red, sore tongue, with no neurological findings. Based on these clinical findings, what will the provider anticipate finding in the laboratory data?

 

  1. Decreased homocysteine levels
  2. Leukopenia and thrombocytopenia
  3. Low hemoglobin and elevated MCV
  4. Normal methylmalonic acid level

 

 

 

  1. A patient reports recent mild fatigue and palpitations. A complete blood count reveals a decreased hemoglobin level and a normal ferritin level. What other findings are likely to be present?

 

Test Bank                                                                                                                                                2

 

 

  1. Decreased hematocrit
  2. Decreased MCV, MCH, and MCHC
  3. Elevated total iron-binding capacity
  4. Paresthesias, koilonychia, and pica

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 238: Blood Coagulation Disorders Test Bank

Multiple Choice

 

 

  1. A male patient has a history of recurrent epistaxis. Prior to a scheduled surgery, the provider asks about a family history of bleeding disorders. The patient reports no female relatives who had excessive bleeding episodes, but states that a maternal uncle and his maternal grandfather both had post-surgical complications related to bleeding. Based on this history, which diagnosis is possible?

 

  1. Hemophilia
  2. Thrombocytopenia
  3. Thrombophilia
  4. Von Willebrand disease

 

 

 

  1. A patient is noted to have prolonged bleeding after an intravenous needle is removed. A subsequent laboratory test reveals a prolonged activated partial thromboplastin (aPTT) time with a normal prothrombin time (PT). Based on this result, the provider may suspect alteration in function of which factor?

 

  1. Factor V
  2. Factor VII
  3. Factor VIII
  4. Factor X

 

 

  1. A patient has type 1 Von Willebrand disease (vWD). What treatment is generally effective to prevent and treat bleeding episodes in this patient?

 

Test Bank                                                                                                                                                2

 

  1. Coagulation factor
  2. Desmopressin
  3. Heparin
  4. Vitamin K

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 239: Leukemias Test Bank

Multiple Choice

 

 

  1. A patient is suspected of having leukemia and the provider orders biochemical studies and a bone marrow aspirate and biopsy. The results include WBCs greater than 200,000 cells/mm3 normal RBCs, hyperplastic myeloid cells, and the absence of serum leukocyte alkaline phosphatase. Which test will the provider order to confirm a diagnosis in this patient?

 

  1. Chest radiograph
  2. Coagulation studies
  3. Philadelphia chromosome test
  4. Serum protein electrophoresis

 

 

 

  1. A child has a recent history of leg pain, unexplained bruising, and nosebleeds. The provider notes petechiae and diffuse lymphadenopathy. A complete blood count reveals a WBC of 30,000 cells/mm3 and near normal RBC and platelet counts. What will the provider do next to manage this patient?

 

  1. Order coagulation studies to evaluate for coagulopathies
  2. Perform biochemical studies to look for hyperuricemia
  3. Refer to a specialist for a bone marrow aspirate and biopsy
  4. Repeat the complete blood count in two weeks

 

 

Test Bank                                                                                                                                                2

 

  1. A patient with acute myelogenous leukemia (AML) who has a high white blood cell count and diffuse lymphadenopathy is hospitalized during the induction phase of chemotherapy. What monitoring and interventions are critical to assess for complications during this phase of care for this patient?

Select all that apply.

 

  1. Administration of sodium bicarbonate and allopurinol
  2. Assessment for bruising and petechiae
  3. Close monitoring of absolute neutrophil counts
  4. Daily renal function and chemistry values
  5. Meticulous assessment of hydration status

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 240: Lymphomas Test Bank

Multiple Choice

 

 

  1. A patient reports a neck mass that has been present off and on for 5 or 6 weeks which varies in size. The provider palpates a lymph node measuring 1.25 cm. Which test will provide proper histologic diagnosis for this patient?

 

  1. Bone marrow aspirate
  2. CT scan with IV contrast
  3. Lymph node biopsy
  4. Positron emission tomography scan

 

 

 

  1. Which types of lymphomas typically have an aggressive presentation? Select all that

 

  1. Adult T cell leukemia-lymphoma
  2. Burkitt lymphoma
  3. Diffuse large B cell lymphoma
  4. Follicular lymphoma
  5. Splenic marginal zone lymphoma

 

 

 

  1. A 30-year-old male patient is diagnosed with Hodgkin lymphoma. Initial lab work reveals a WBC of 20 × 109/L, hemoglobin of 10.1 gm/dL, a serum albumin of 45 gm/dL, and lymphopenia of 0.5 × 109/L. Staging studies identify stage III disease. What is this patient’s prognostic score?

 

  1. 2
  2. 3

 

Test Bank                                                                                                                                                2

 

  1. 4
  2. 5

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 241: Myelodysplastic Syndromes Test Bank

Multiple Choice

 

 

  1. A 70-year-old patient reports frequent infections, shortness of breath, fatigue, and palpitations. An exam reveals pallor and petechiae. The provider orders a peripheral blood smear and bone marrow biopsy. Which findings are consistent with a diagnosis of myelodysplasia?

Select all that apply.

 

  1. Anisocytosis and poikilocytosis of erythrocytes on peripheral smear
  2. Defects in cellular maturation in all cell lines in bone marrow aspirate
  3. Hypercellular bone marrow with peripheral cytopenia
  4. Larger than normal megakaryocytes in bone marrow
  5. Smaller than normal granulocytes in the peripheral blood smear

 

 

 

  1. A patient with myelodysplastic syndrome (MDS) has severe neutropenia and anemia is given erythropoietin (EPO) with improvement in hemoglobin. Which intervention has been shown to prevent infection in patients with MDS who have severe neutropenia?

 

  1. Antithymocyte globulin and cyclosporine
  2. Granulocyte-macrophage colony-stimulating factor (GM-CSF)
  3. Intravenous immunoglobulin infusions
  4. Prophylactic treatment with floroquinolones

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 242: Collaborative Management of the Oncology Patient Test Bank

Multiple Choice

 

 

  1. A patient being treated for cancer has had chemotherapy within the past two weeks and comes to the primary care clinic with a fever of 38.5° C. What is the initial action?

 

  1. Obtain a STAT CBC with differential
  2. Order a chest radiograph
  3. Order blood and urine cultures
  4. Prescribe empiric antibiotics

 

 

 

  1. What is the most important role of the primary care provider in cancer management?

 

  1. Counseling about healthy practices to reduce risk factors
  2. Performing regular screenings to detect cancer
  3. Referring patients for genetic testing to identify those at risk
  4. Teaching patients about cancer management once diagnosed

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 243: Basic Principles of Oncology Treatment Test Bank

Multiple Choice

 

 

  1. An oncology specialist recommends placement of radioactive isotopes in capsules near a patient’s tumor. What is this form of radiation therapy called?

 

  1. Brachytherapy
  2. CT simulation
  3. External beam
  4. Fractionation

 

 

 

  1. Which chemotherapeutic agent classes are S-phase specific agents? Select all that

 

  1. Asparaginase
  2. Bleomycin
  3. Fluorouracil
  4. Mercaptopurine
  5. Methotrexate

 

 

 

  1. What is the purpose of radiation treatment prior to surgical resection of a tumor?

 

  1. To debulk the tumor mass
  2. To minimize local recurrence
  3. To prevent metastases
  4. To reduce pain and bleeding

 

Test Bank                                                                                                                                          2

 

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 244: Oncology Complications and Paraneoplastic Syndromes Test Bank

Multiple Choice

 

 

  1. A patient who has non-Hodgkin’s lymphoma reports a dull, aching back pain in the thoracic region for several weeks along with difficulty walking. The provider notes an ataxic gait. What is the immediate treatment for this condition?

 

  1. Chemotherapy
  2. Radiation therapy
  3. Steroid therapy
  4. Surgical decompression

 

 

  1. Which are considered oncologic emergencies in a patient with cancer requiring urgent referral to an oncologist?

Select all that apply.

 

  1. Bone marrow suppression
  2. Metastasis of cancer cells
  3. Superior vena cava syndrome
  4. Syndrome of inappropriate antidiuretic hormone
  5. Tumor lysis syndrome

 

 

 

  1. A patient is in the induction phase of chemotherapy just after diagnosis of cancer. Which prophylactic measures will help prevent tumor lysis syndrome?

Select all that apply.

 

  1. Acidifying the urine
  2. Initiation of allopurinol

 

Test Bank                                                                                                                                                2

 

  1. Intravenous fluids of 3000 mL/day
  2. Rasburicase administration
  3. Sodium polystyrene sulfonate

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 245: Oncology Pain and Symptom Management in Primary Care Test Bank

Multiple Choice

 

 

  1. A patient with cancer is expected to require long-term pain medication to manage cancer pain. Which agent will be best for this patient?

 

  1. Ibuprofen
  2. Meperidine
  3. Morphine
  4. Naloxone

 

 

 

  1. A patient with breast cancer has been symptom-free for 6 months and reports a new onset of lower back pain rated as an 8 on a 1 to 10 pain rating scale to the primary provider. What is most important when evaluating this patient’s pain?

 

  1. Evaluating the possibility of drug-seeking behavior
  2. Obtaining an MRI of the spinal cord
  3. Prescribing a trial of oral opioid medication
  4. Referring the patient to the oncologist

 

 

 

  1. A patient with cancer is reluctant to take an opioid agonist medication because of the side effects. What will the primary care provider recommend?

 

  1. Adding an NSAID to the pain regimen
  2. Taking a stool softener with the opioid
  3. Using diphenhydramine to prevent itching

 

Test Bank                                                                                                                                                2

  1. Using opioids on an as needed basis only

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 246: Unknown Primary Carcinoma Test Bank

Multiple Choice

 

 

  1. A patient is determined to have an unknown primary carcinoma after a metastatic lesion is found in the lymph nodes. A blood test reveals that the patient has microcytic anemia. Which diagnostic test will the provider consider next to help determine the primary tumor?

 

  1. Alpha-fetoprotein and human chorionic gonadotropin levels
  2. Endoscopic evaluation of the upper and lower GI tract
  3. Positron emission tomography-computed tomography scan
  4. Prostate specific antigens

 

 

 

  1. A female patient is diagnosed with unknown primary carcinoma (UPC) after a metastatic squamous cell carcinoma is found. She asks the provider for an estimate about survival. What is the median survival rate for this type of UPC?

 

  1. 9 months
  2. 12 months
  3. 24 months
  4. 33 months

 

 

 

  1. A woman has carcinomas confined to axillary nodes. A mammogram is normal. What is the next step in managing this patient?

 

  1. Begin treatment for primary breast tumor
  2. Evaluate HER-2 and estrogen and progesterone receptors

 

Test Bank                                                                                                                                                2

 

  1. Order an MRI of the breasts
  2. Reassure the patient that she probably does not have cancer

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 247: Anxiety Disorders Test Bank

Multiple Choice

 

 

  1. A patient is diagnosed with panic disorder and begins taking a selective serotonin reuptake inhibitor medication. Six weeks later, the patient reports little relief from symptoms. What will the provider do next to manage this patient?

 

  1. Change the medication to buspirone
  2. Discontinue the medication
  3. Increase the medication dose
  4. Refer to a mental health provider

 

 

 

  1. Which medication are useful in treating both obsessive-compulsive disorder and PTSD? Select all that

 

  1. Benzodiazepines
  2. Buspirone
  3. Selective serotonin reuptake inhibitors
  4. Serotonin-norepinephrine reuptake inhibitors
  5. Tricyclic antidepressants

 

 

  1. A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines that these symptoms occur in relation to many events and concerns. What other things will the provider question this patient about?

 

  1. Ability to manage social situations

 

Test Bank                                                                                                                                                2

 

  1. Body image and eating habits
  2. Headaches and bowel habits
  3. Occupational performance

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 248: Mood Disorders Test Bank

Multiple Choice

 

 

  1. A patient is seen in clinic 2 weeks after the death of a parent. The patient reports feelings of sadness and hopelessness and a feeling that the parent is still present, even to the point of hearing the parent’s voice at times. What will the provider determine from these findings?

 

  1. There is a concern for
  2. There is a possibility of manic
  3. These are concerning for
  4. These are normal grief

 

 

 

  1. A college student is brought to clinic by a parent who is concerned about increasingly bizarre behavior and poor school performance. The provider notes difficulty engaging the patient in an organized conversation. The patient denies any concerns about behavior. What will the provider do initially to manage this patient’s symptoms?

 

  1. Admit the patient for inpatient treatment
  2. Begin treatment with lithium or lamotrigine
  3. Counsel the parent to report any symptoms of depression
  4. Schedule an appointment with a psychiatrist

 

 

  1. A patient is seen frequently over a 9-month period with somatic complaints that are not related to physical disease. The primary provider notes that the patient has had a 15% weight

 

Test Bank                                                                                                                                                2

 

loss in the previous 2 months and the patient reports difficulty sleeping. The spouse tells the provider that the patient seems tired all the time and is irritable with other family members. What will the provider do initially?

 

  1. Perform a suicide risk assessment
  2. Prescribe a selective serotonin reuptake inhibitor
  3. Refer the patient for psychotherapy
  4. Suggest cognitive-behavioral therapy

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 249: Substance Use Disorders Test Bank

Multiple Choice

 

 

  1. A patient is brought to the emergency department who is experiencing disorientation, confusion, and fever. The patient describes visual and auditory hallucinations. The patient’s spouse states that the patient had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended treatment?

 

  1. Benzodiazepines
  2. Intravenous fluids and rest
  3. Naloxone
  4. Phenobarbital

 

 

 

  1. A college student is brought to the emergency department by a roommate who is concerned about symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects withdrawal from which substance?

 

  1. Alcohol
  2. Cocaine
  3. LSD
  4. Opioids

 

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 250: Other Mental Health Disorders Test Bank

Multiple Choice

 

 

  1. A 17-year-old male is brought to the clinic by a parent who is concerned that the patient has become more isolated and withdrawn and expresses suspicions that his teachers hate him and want him to fail. What will the provider tell this parent?

 

  1. The adolescent should be evaluated by a
  2. The adolescent should be given a trial of antipsychotic
  3. These are common adolescent behaviors and will eventually go
  4. These signs are diagnostic for

 

 

 

  1. A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of college and quit his job within the last 5 months. The parent is concerned that the patient may have schizophrenia because a maternal uncle has the disease. What will the provider do next?

 

  1. Ask about the patient’s speech and thinking patterns
  2. Consider treatment with antipsychotic medications
  3. Reassure that classic symptoms of schizophrenia are not present
  4. Refer the patient for inpatient psychiatric treatment

 

 

 

  1. Which are considered “negative” symptoms of schizophrenia?

 

Test Bank                                                                                                                                                2

 

Select all that apply.

 

  1. Auditory hallucinations
  2. Delusions of persecution
  3. Impaired self care
  4. Poor school performance
  5. Withdrawing from peers

 

 

Test Bank                                                                                                                                                2

 

  1. A patient who was initially treated as an outpatient for pneumonia and then hospitalized for two weeks after no improvement continues to show no improvement after several antibiotic regimens have been attempted. What is the next step in managing this patient?

 

  1. Administration of the pneumonia vaccine
  2. Increasing the dose of the antibiotics
  3. Open lung biopsy
  4. Performing diagnostic bronchoscopy

 

 

Test Bank                                                                                                                                                2

  1. Waiting for all skin to become depigmented

 

 

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