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Operant Conditioning

Operant Conditioning (Worth 30 Points)

The purpose of this writing assignment is to apply critical thinking skills to conduct a real-life application of operant conditioning.

Learning Objectives 3c and 5c

Select a target behavior that you would like to strengthen in a person or animal in which you have daily contact. For example, you may choose to have your child pick up his/her toys more often; try to get more hugs from your significant other; train a dog to sit on command, etc.  Try to avoid selecting a target behavior you would like to weaken, which would require the use of positive punishment (punishment by application) or negative punishment (punishment by removal).

Step 1 Written Portion: State your target behavior. If you choose a target behavior in an animal, include the animal’s name, age, gender, and breed.  If you choose a target behavior in a person, include his or her first name, age, and relationship to you (such as a friend, co-worker, child, or significant other).

Once you have decided on a target behavior, collect data over the next day to find out how often the target behavior occurs without your guidance or reinforcement. In other words, just observe and count the times the target behavior occurs on its own. For example, if you choose the following target behavior: Teaching your dog how to roll over on command, then you would give the roll over command and count the times the dog rolls over (without your interference or guidance). This data is called the baseline frequency.

Step 2 Written Portion:  State your baseline frequency data. Describe your data collection, including the number of hours observed, where you observed the target behavior, and any other relevant information. Also, report any biases that may be introduced in your baseline frequency data collection. For instance, if you are doing your baseline frequency count on the number of times your dog sits on command, and you observe your pet during an obedience class, a bias will be introduced.

*Please note*: A baseline frequency of one day will implement a bias in your study. Report the bias, stating that a baseline frequency observed and recorded over several days may produce a more valid and reliable record of the target behavior.

On the next day, begin the process of operant conditioning. The first time the target behavior occurs; reinforce it with a behavior that you believe has meaning to the person/animal. Think through your operant conditioning terms. For instance, if the target behavior occurs, and you respond with “Great Job,” your compliment is positive reinforcement with a secondary/conditioned reinforcer, which increases the likelihood the target behavior will occur again.

If the baseline frequency is 0, in other words, if the target behavior does not occur on its own, then you will need to employ the technique of shaping.

Step 3 Written Portion: Write a paragraph reporting the number of times the target behavior occurred during the operant conditioning phase.  Explain why you think the target behavior increased, decreased, or stayed the same.  Use your operant conditioning terms to describe what you did, including your use of primary or secondary/conditioned reinforcers of positive reinforcement.  Also, explain if and how you used escape or avoidance conditioning of negative reinforcement. In addition, identify if you stayed with one type of effective reinforcer or if you used many.  Also, if you used shaping because the target behavior did not occur on its own, discuss how you applied shaping. Lastly, describe what you may have done differently, and report any conclusions you may have about your operant conditioning efforts.

Film Feedback Analysis Paper

Film Feedback Analysis Paper

The film analysis paper is designed to be a short essay, which allows you to begin thinking about the movie(s). Writing helps you to think, since you have to articulate your otherwise unformed or vague thoughts. This, in turn, will help us to have a good discussion of the film(s) with others, including on the message board. While it is not required to complete this before the message board, it may be helpful.The essay should be approximately 500-700 words. This should not summarize the plots /story of the films, except where it is necessary to make your examples clear, since your reader(s) has seen it.Rather, devote your limited words to ANALYZING or giving feedback on the film.In your analysis, you need to address the following questions, not necessarily in this order and certainly not as a checklist, but rather in the form of an essay, with a thesis statement, specific examples drawn from the film, and with a conclusion.

  1. What is the film’s goal? Or when doing two films, what were the goals?
  2. How well has the goal been accomplished?
    1. What are the primary conflicts in the movie(s)?
    2. How do they contribute to the movie’s goal / meaning?
  3. What sociological/religious/cultural issues does the movie(s)? If 2 movies, give similarities or contrasts.
  4. What does it simulate you to think about? Does it have any impact on how you view sport or society?

Your essay should incorporate discussion of technical issues related to film making (at least some you notice). These sort of issues might relate to issues such as:

  1. mise-en-scene (arrangement of scenery or settings)
  2. music
  3. lighting / color
  4. acting / casting
  5. sets / costume

The instructor does not expect you to be evaluating these things at a high level, but please look for them. How does it impact the story?

Format and Submission

The instructor is fully aware that most of these movies have reviews and analysis online. Please be cautious in using these as you will tend to analyze the films from that writers perspective, and not your own. Use your experience and background, especially the sport related ones, not someone else’s. Or worse, you will be tempted to plagiarize which can cost you your grade or graduate student status. Use your words and ideas.The paper will be submitted via dropbox by deadline listed in syllabusThey should be double spaced, with one-inch margins, using Times New Roman, 12pt font. They should have an interesting title (not just the name of the movie!) and your name should appear at the top of the first page.The last part of your analysis paper will be the honor statement (this won’t count towards the word limit!):On my word of honor, I have completely viewed the movie (or movies) that I am analyzing.==================================================================Film analysis papers will be graded using the following rubric. Before you submit your paper, you should examine it carefully and think about how you would fill this rubric for your own paper.Paper rubricScorePossItem2Introduction / Conclusion: Does the paper have an introductory paragraph with a clear and argumentative thesis statement? Is it clear what you are going to discuss?1Organization: Is the essay clearly organized? How a paragraph relates to its predecessor and successor should be clear. Does the paper have effective transitions from example to example? Each paragraph should discuss only one example. Does the paper do this or are there multiple points made in a paragraph?6Assignment: Does the paper address the questions posed:

  1. What is the film’s goal? Or when doing two films, what were the goals?
  2. How well has the goal been accomplished?
    1. What are the primary conflicts in the movie?
    2. How do they contribute to the movie’s goal / meaning?
  3. What sociological/religious/cultural issues does the movie(s)? If 2 movies, give similarities or contrasts.
  4. What does it simulate you to think about? Does it have any impact on how you view sport or society?

2Examples: Does the paper cite specific examples from the readings to support the argument? Does it spend too much time summarizing the film? Or does it briefly describe scenes to facilitate their analysis?2Mechanics and Grammar: Does the paper follow APA guidelines, citation guidelines, and have an honor- statement?Is the paper written in formal, academic English, without spelling mistakes, punctuation errors, etc?2Filmmaking storytelling: Does the paper attempt to identify film making or storytelling techniques, and the purposes for doing so.15One last very important point. Perhaps you really want to write about some other aspect of the film that does not really fit. Perhaps it is a character or situation that you really connect with. Perhaps there is a current event that you want to relate these films to. Or maybe you just have a really good idea that doesn’t fit with the above rubric. If that applies to you, then please write on that topic. If you want to go longer than what is mentioned above, then just make sure it is well written. Explore your ideas. It need not fit the above flow.It does need the following, however.

  • Honor statement.
  • Connection of both movies. It does not need to be an equal balance, but there should be some commonalities or points of connection.
  • A connection to recreation, sport, or leisure.
  • Some meaningful theme throughout.

NSG 6020 Final Exam Latest

A 22-year-old advertising copywriter presents for evaluation of joint pain. The pain is new, located in the wrists and fingers bilaterally, with some subjective fever. The patient denies a rash; she also denies recent travel or camping activities. She has a family history significant for rheumatoid arthritis. Based on this information, which of the following pathologic processes would be the most correct?
A) Infectious
B) Inflammatory
C) Hematologic
D) Traumatic

Question 2

A 35-year-old archaeologist comes to your office (located in Phoenix, Arizona) for a regular skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered across her skin. From this description, which of the following is not a risk factor for melanoma in this patient?
A) Age
B) Hair color
C) Actinic lentigines
D) Heavy sun exposure

Question 3

A 15-year-old high school sophomore and her mother come to your clinic because the mother is concerned about her daughter’s weight. You measure her daughter’s height and weight and obtain a BMI of 19.5 kg/m2. Based on this information, which of the following is appropriate?
A) Refer the patient to a nutritionist and a psychologist because the patient is anorexic.
B) Reassure the mother that this is a normal body weight.
C) Give the patient information about exercise because the patient is obese.
D) Give the patient information concerning reduction of fat and cholesterol in her diet because she is obese.

Question 4

A middle-aged man comes in because he has noticed multiple small, blood-red, raised lesions over his anterior chest and abdomen for the past several months.They are not painful and he has not noted any bleeding or bruising. He is concerned this may be consistent with a dangerous condition. What should you do?
A) Reassure him that there is nothing to worry about.
B) Do laboratory work to check for platelet problems.
C) Obtain an extensive history regarding blood problems and bleeding disorders.
D) Do a skin biopsy in the office.

Question 5

Jacob, a 33-year-old construction worker, complains of a “lump on his back” over his scapula. It has been there for about a year and is getting larger. He says his wife has been able to squeeze out a cheesy-textured substance on occasion. He worries this may be cancer. When gently pinched from the side, a prominent dimple forms in the middle of the mass. What is most likely?
A) An enlarged lymph node
B) A sebaceous cyst
C) An actinic keratosis
D) A malignant lesion

Question 6

A patient comes to you for the appearance of red patches on his forearms that have been present for several months. They remain for several weeks. He denies a history of trauma. Which of the following is likely?
A) Actinic keratoses
B) Pseudoscars
C) Actinic purpura
D) Cherry angiomas

Question 7

A 19-year old-college student presents to the emergency room with fever, headache, and neck pain/stiffness. She is concerned about the possibility of meningococcal meningitis. Several of her dorm mates have been vaccinated, but she hasn’t been. Which of the following physical examination descriptions is most consistent with meningitis?
A) Head is normocephalic and atraumatic, fundi with sharp discs, neck supple with full range of motion
B) Head is normocephalic and atraumatic, fundi with sharp discs, neck with paraspinous muscle spasm and limited range of motion to the right
C) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck tender to palpation, unable to perform range of motion
D) Head is normocephalic and atraumatic, fundi with blurred disc margins, neck supple with full range of motion

Question 8

A 58-year-old gardener comes to your office for evaluation of a new lesion on her upper chest. The lesion appears to be “stuck on” and is oval, brown, and slightly elevated with a flat surface. It has a rough, wartlike texture on palpation. Based on this description, what is your most likely diagnosis?
A) Actinic keratosis
B) Seborrheic keratosis
C) Basal cell carcinoma
D) Squamous cell carcinoma

Question 9

A patient presents for evaluation of a cough. Which of the following anatomic regions can be responsible for a cough?
A) Ophthalmologic
B) Auditory
C) Cardiac
D) Endocrine

Question 10

A 72-year-old retired truck driver comes to the clinic with his wife for evaluation of hearing loss. He has noticed some decreased ability to hear what his wife and grandchildren are saying to him. He admits to lip-reading more. He has a history of noise exposure in his young adult years: He worked as a sound engineer at a local arena and had to attend a lot of concerts. Based on this information, what is the most likely finding regarding his hearing acuity?
A) Loss of acuity for middle-range sounds
B) Increase of acuity for low-range sounds
C) Loss of acuity for high-range sounds
D) Increase of acuity for high-range sounds

Question 11

Mrs.Anderson presents with an itchy rash which is raised and appears and disappears in various locations. Each lesion lasts for many minutes. What most likely accounts for this rash?
A) Insect bites
B) Urticaria, or hives
C) Psoriasis
D) Purpura

Question 12

A new mother is concerned that her child occasionally “turns blue.” On further questioning, she mentions that this is at her hands and feet. She does not remember the child’s lips turning blue. She is otherwise eating and growing well. What would you do now?
A) Reassure her that this is normal
B) Obtain an echocardiogram to check for structural heart disease and consult cardiology
C) Admit the child to the hospital for further observation
D) Question the validity of her story

Question 13

An 89-year-old retired school principal comes for an annual check-up. She would like to know whether or not she should undergo a screening colonoscopy. She has never done this before. Which of the following factors should not be considered when discussing whether she should go for this screening test?
A) Life expectancy
B) Time interval until benefit from screening accrues
C) Patient preference
D) Current age of patient

Question 14

You are speaking to an 8th grade class about health prevention and are preparing to discuss the ABCDEs of melanoma. Which of the following descriptions correctly defines the ABCDEs?
A) A = actinic; B = basal cell; C = color changes, especially blue; D = diameter >6 mm; E = evolution
B) A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6 mm; E = evolution
C) A = actinic; B = irregular borders; C = keratoses; D = dystrophic nails; E = evolution
D) A = asymmetry; B = regular borders; C = color changes, especially orange; D = diameter >6 mm; E = evolution

Question 15

A 79-year-old retired banker comes to your office for evaluation of difficulty with urination; he gets up five to six times per night to urinate and has to go at least that often in the daytime. He does not feel as if his bladder empties completely; the strength of the urinary stream is diminished. He denies dysuria or hematuria. This problem has been present for several years but has worsened over the last 8 months. You palpate his prostate. What is your expected physical examination finding, based on this description?
A) Normal size, smooth
B) Normal size, boggy
C) Enlarged size, smooth
D) Enlarged size, boggy

Question 16

A young man comes to you with an extremely pruritic rash over his knees and elbows which has come and gone for several years. It seems to be worse in the winter and improves with some sun exposure. On examination, you notice scabbing and crusting with some silvery scale, and you are observant enough to notice small “pits” in his nails. What would account for these findings?
A) Eczema
B) Pityriasis rosea
C) Psoriasis
D) Tinea infection

Question 17

A 15-year-old high school sophomore comes to the clinic for evaluation of a 3-week history of sneezing; itchy, watery eyes; clear nasal discharge; ear pain; and nonproductive cough. Which is the most likely pathologic process?
A) Infection
B) Inflammation
C) Allergic
D) Vascular

Question 18

A 68-year-old retired farmer comes to your office for evaluation of a skin lesion. On the right temporal area of the forehead, you see a flattened papule the same color as his skin, covered by a dry scale that is round and feels hard. He has several more of these scattered on the forehead, arms, and legs.Based on this description, what is your most likely diagnosis?
A) Actinic keratosis
B) Seborrheic keratosis
C) Basal cell carcinoma
D) Squamous cell carcinoma

Question 19

An 8-year-old girl comes with her mother for evaluation of hair loss. She denies pulling or twisting her hair, and her mother has not noted this behavior at all. She does not put her hair in braids. On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation. There are no hair shafts visible. Based on this description, what is your most likely diagnosis?
A) Alopecia areata
B) Trichotillomania
C) Tinea capitis
D) Traction alopecia

Question 20

A 19-year-old construction worker presents for evaluation of a rash. He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck. It itches a lot. He does sweat more than before because being outdoors is part of his job. On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms. Based on this description, what is your most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema

Question 21

Which of the following booster immunizations is recommended in the older adult population?
A) Tetanus
B) Diphtheria
C) Measles
D) Mumps

Question 22

A patient presents for evaluation of a sharp, aching chest pain which increases with breathing. Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine

Question 23

Ms.Whiting is a 68 year old who comes in for her usual follow-up visit. You notice a few flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else. She doesn’t mention them. They are tender when you examine them. What should you do?
A) Conclude that these are lesions she has had for a long time.
B) Wait for her to mention them before asking further questions.
C) Ask how she acquired them.
D) Conduct the visit as usual for the patient.

Question 24

You have recently returned from a medical missions trip to sub-Saharan Africa, where you learned a great deal about malaria. You decide to use some of the same questions and maneuvers in your “routine” when examining patients in the midwestern United States. You are disappointed to find that despite getting some positive answers and findings, on further workup, none of your patients has malaria except one, who recently emigrated from Ghana. How should you next approach these questions and maneuvers?
A) Continue asking these questions in a more selective way.
B) Stop asking these questions, because they are low yield.
C) Question the validity of the questions.
D) Ask these questions of all your patients.

Question 25

On routine screening you notice that the cup-to-disc ratio of the patient’s right eye is 1:2. What ocular condition should you suspect?
A) Macular degeneration
B) Diabetic retinopathy
C) Hypertensive retinopathy
D) Glaucoma

Question 26

Mrs.Hill is a 28-year-old African-American with a history of SLE (systemic lupus erythematosus). She has noticed a raised, dark red rash on her legs. When you press on the rash, it doesn’t blanch. What would you tell her regarding her rash?
A) It is likely to be related to her lupus.
B) It is likely to be related to an exposure to a chemical.
C) It is likely to be related to an allergic reaction.
D) It should not cause any problems.

Question 27

A 47-year-old contractor presents for evaluation of neck pain, which has been intermittent for several years. He normally takes over-the-counter medications to ease the pain, but this time they haven’t worked as well and he still has discomfort. He recently wallpapered the entire second floor in his house, which caused him great discomfort. The pain resolved with rest. He denies fever, chills, rash, upper respiratory symptoms, trauma, or injury to the neck. Based on this description, what is the most likely pathologic process?
A) Infectious
B) Neoplastic
C) Degenerative
D) Traumatic

Question 28

A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On physical examination, you note that the pattern of eruption is like a Christmas tree and that there are a variety of erythematous papules and macules on the cleavage lines of the back. Based on this description, what is the most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema

Question 29

Which of the following changes are expected in vision as part of the normal aging process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision

Question 30

You are examining an unconscious patient from another region and notice Beau’s lines, a transverse groove across all of her nails, about 1 cm from the proximal nail fold. What would you do next?
A) Conclude this is caused by a cultural practice.
B) Conclude this finding is most likely secondary to trauma.
C) Look for information from family and records regarding any problems which occurred 3 months ago.
D) Ask about dietary intake.

Side PanelExpand Side Panel Breadcrumb: 6-2 Journal: Self-Analysis: Behavioral Competency: The Interpersonal Domain

Side PanelExpand Side Panel Breadcrumb: 6-2 Journal: Self-Analysis: Behavioral Competency: The Interpersonal Domain

Instructions

First, review the required module resources, examining the behavioral competencies within the interpersonal domain. As a reminder, the three main clusters within the interpersonal domain are relationship management, global and cultural effectiveness, and communication. Once you are familiar with the interpersonal domain clusters, conduct a self-reflection and analysis by responding to each of the following three questions:

  • Strengths: What are your areas of strength within the interpersonal domain, and how did you determine a cluster as a strength? Provide supportive examples.
  • Weaknesses: What are your areas of weakness within the interpersonal domain, and how did you determine a cluster as a weakness? Provide supportive examples.
  • Strategies: What are your strategies for the development of behavioral competencies within the interpersonal domain? Provide supportive examples and information from your research.

To complete this assignment, review the Module Six Journal Guidelines and Rubricdocument.

Gender Influences at Work

Assignment: Gender Influences at Work

Ideally, people select and pursue their careers based on their personal interests, their abilities, and their desire to make a contribution in/to a particular arena. However, the ideal is not always realized for a variety of reasons. One such reason is the presence of gender stereotyping related to aptitude for a specific career or skill, jobs, and careers, in general. Gender stereotyping may begin in school with girls and boys who are encouraged to pursue careers that stereotypically appear to be more fitting for one gender or the other. This type of stereotyping often results in discrimination and harassment in the school or training for the field, discrimination in the workplace, closed doors for some types of employment, and limited career opportunities.

Psychologists have posed many justifications for the stereotyping that impacts career choice and career success. It may be that boys and girls are directed differently to specific careers beginning in early education. It may be that parents influence their children toward or away from specific career paths by their expectations, dialogue, and even toys they give their children to play with. It may be the stereotyping and resulting discrimination related to training and education that influences the career paths of men and women. It may be the influence from society in general related to what are considered to be appropriate roles for both men and women.

Additional gender-related challenges exist once men and women get to the workplace. Though discrimination and sexual harassment are often seen as women’s issues, men also experience discrimination and sexual harassment, especially in typically female-dominated occupations such as teaching, childcare, nursing, and some administrative positions. And while there may be a reduction in the occurrence of stereotyping, women historically have experienced discrimination that results in not being hired or promoted to upper management positions, unequal pay for equal work, and “glass ceilings” in many fields including health care, engineering, science, math, and protective services, just to name a few.

Psychologists continue to look for answers about why men and women behave differently and are treated differently in the workplace. Common explanations include the differences in communication styles often seen in men and women, issues associated with power struggles in the workplace, and societal expectations regarding roles of men and women.

To prepare for this assignment:

  • Review Chapter 12 in the course text, Gender: Psychological Perspectives. Focus on the gender-related differences and similarities in issues related to career selection, career success, and the work environment.
  • Review the articles, “The Compassionate Sexist? How Benevolent Sexism Promotes and Undermines Gender Equality in the Workplace,” and “Gender Inequalities in the Workplace: The Effects of Organizational Structures, Processes, Practices, and Decision Makers’ Sexism.”
  • Think about one specific career path, such as architecture, engineering, science, nursing, business management, etc. Conduct research on the current gender-related statistics for the career path you have selected.
  • Consider the following questions, using the Week 6 Optional Resources or other resources of your choosing:
    • What is the workplace like, and how might workplace conditions, requirements, and/or environmental factors influence or be influenced by each gender?
    • Is the field typically a male- or female-dominated one? Why?
    • Is there a salary difference between the genders?
  • Think about the following questions:
    • How and why might boys and girls be directed differently to the career path you selected and researched?
    • What challenges might each gender face in getting a job in this area?
    • Once individuals enter this career, how might men and women be treated differently and how might they behave differently? What are the unique challenges each gender must address in order to succeed in this area?

The assignment (3–4 pages):

  • Select a career path (e.g., architecture, engineering, nursing, business management, etc.).
  • Analyze the impact that gender has in:
    • The career choice itself, including gender stereotyping within that career
    • Other factors that might influence career choice, obstacles to entering the career, and factors that impact career success
    • The work setting within that career, including factors that might lead to discrimination, communication differences that impact workplace success, issues related to power, and rates of sexual harassment

Note: Be sure to protect the identity of any persons you describe.

Note: Support the responses within your Assignment with evidence from the assigned Learning Resources, including in-text citations. Provide a reference list for resources you used for this Assignment

NR 509 Week4 Quiz Advanced Physical Assessment Chamberlain

1. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?

a. Hard and fixed cervical nodes

b. Enlarged and tender inguinal nodes

c. Bilateral enlargement of the popliteal nodes

d. Pelletlike nodes in the supraclavicular region

2. The direction of blood flow through the heart is best described by which of these

a. Vena cava right atrium right ventricle lungs pulmonary artery left atrium left ventricle

b. Right atrium right ventricle pulmonary artery lungs pulmonary vein left atrium left ventricle

c. Aorta right atrium right ventricle lungs pulmonary vein left atrium left ventricle vena cava

d. Right atrium right ventricle pulmonary vein lungs pulmonary artery left atrium left ventricle

3. In assessing the carotid arteries of an older patient with cardiovascular disease, the FNP would

a. Palpate the artery in the upper one third of the neck.

b. Listen with the bell of the stethoscope to assess for bruits.

c. Simultaneously palpate both arteries to compare amplitude.

d. Instruct the patient to take slow deep breaths during auscultation.

4. When listening to heart sounds the FNP knows that the valve closures that can be heard best at the base of the heart are

a. mitral, tricuspid.

b. tricuspid, aortic.

c. aortic, pulmonic.

d. mitral, pulmonic.

5. The sack that surrounds and protects the heart is called the

a. pericardium.

b. myocardium.

c. endocardium.

d. pleural space.

6. When assessing a newborn infant who is five minutes old the FNP knows that which of these statements would be true?

a. The left ventricle is larger and weighs more than the right.

b. The circulation of a newborn is identical to that of an adult.

c. There is an opening in the atrial septum where blood can flow into the left side of the heart.

d. The foramen ovale closes just minutes before birth and the ductus arteriosus closes immediately after.

7. The FNP is performing an assessment on an adult. The adults vital signs are normal and capillary refill is five seconds. What should the FNP do next?

a. ask the parent if the child has had frostbite in the past.

b. suspect that the child has a venous insufficiency problem.

c. consider this a delayed capillary refill time and investigate further.

d. consider this a normal capillary refill time that requires no further assessment.

8. During an assessment of an older adult the FNP should expect to notice which finding as normal physiologic change associated with aging process?

a. Hormonal changes causing vasodilation and a resulting drop in blood pressure

b. Progressive atrophy of the intramuscular calf veins, causing venous insufficiency

c. Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure

d. Narrowing of the inferior vena cava, causing low blood flow and increases in venous pressure resulting in varicosities

9. The mother of a three month old infant states that her baby has not been gaining weight. With further questioning the FNP finds that the infant falls asleep after nursing and wakes up after a short amount of time hungry again. What other information with the FNP want to have?

a. The position that baby sleeps in

b. Sibling history of eating disorders

c. Amount of background noise when eating

d. Presence of dyspnea or diaphoresis when sucking

10. In assessing a patient’s major risk factors for heart disease which would the FNP want to include when taking a history?

a. Family history, hypertension, stress, age

b. Personality type, high cholesterol, diabetes, smoking

c. Smoking, hypertension, obesity, diabetes, high cholesterol

d. Alcohol consumption, obesity, diabetes, stress, high cholesterol

11. The FNP is assessing… the pulses of a patient who has been admitted for untreated hyperthyroidism. The FNP should expect to find a—— pulse

a. normal

b. absent

c. bounding

d. weak, thread

12. A patient complains of leg pain that wakes him at night. He states that he has been having problems with his legs. He has pain in his legs his legs when they are elevated, which disappears when he dangles them. He recently noticed a sore on the inner aspect of his right ankle. On the basis of this history information the FNP interprets that the patient is most likely experiencing

a. pain related to lymphatic abnormalities.

b. problems related to arterial insufficiency.

c. problems related to venous insufficiency.

d. pain related to musculoskeletal abnormalities.

13. During an assessment the FNP uses the profile sign to detect

a. Pitting edema.

b. Early clubbing.

c. Symmetry of the fingers.

d. Insufficient capillary refill.

14. Which of these statements describes the closure of the valves in a normal cardiac cycle?

a. The aortic valve closes slightly before the tricuspid valve.

b. The pulmonic valve closes slightly before the aortic valve.

c. The tricuspid valve closes slightly later than the mitral valve.

d. Both the tricuspid and pulmonic valves close at the same time.

15. When performing a peripheral vascular assessment on a patient the FNP is unable to palpate the ulnar pulses. The patient skin is warm and capillary refill is normal. The FNP should next

a. check for the presence of claudication.

b. refer the individual for further evaluation.

c. consider this a normal finding and proceed with the peripheral vascular evaluation.

d. ask the patient if he or she has experienced any unusual cramping or tingling in the arm.

16. A 67-year-old patient states that he “recently began have pain in his left calf when climbing the 10 stairs to his apartment”. This pain is relieved by sitting for about two minutes then he’s able to resume activities. The FNP interprets this patient is most likely experiencing

a. Claudication.

b. Sore muscles.

c. Muscle cramps.

d. Venous insufficiency.

17. In assessing a 70-year-old man the FNP finds the following blood pressure 140/100 mmHg, heart rate 104 and slightly irregular, split S2. Which of these findings can… by expected hemodynamic changes related to age?

a. Increase in resting heart rate

b. Increase in systolic blood pressure

c. Decrease in diastolic blood pressure

d. Increase in diastolic blood pressure

18. The FNP is examining the lymphatic system of a healthy three year old child. Which finding should the FNP expect?

a. Excessive swelling of the lymph nodes

b. The presence of palpable lymph nodes

c. No nodes palpable because of the immature immune system of a child

d. Fewer numbers and a decrease in size of lymph nodes compared with those of an adult

19. The FNP is preparing to perform modified Allen test. Which is an appropriate reason for this test?

a. To measure the rate of lymphatic drainage

b. To evaluate the adequacy of capillary patency before venous blood draws

c. To evaluate the adequacy of collateral circulation before cannulating the radial artery

d. To evaluate the venous refill rate that occurs after the ulnar and radial arteries are temporarily occluded

20. A 25-year-old woman is in her fifth month of pregnancy has a blood pressure of 100/70 mmHg. In reviewing her previous exam the FNP notes that her blood pressure in her second month was 124/80 mmHg. When evaluating this change what does the FNP know to be true?

a. This is the result of peripheral vasodilatation and is an expected change.

b. Because of increased cardiac output, the blood pressure should be higher this time.

c. This is not an expected finding because it would mean a decreased cardiac output.

d. This would mean a decrease in circulating blood volume, which is dangerous for the fetus

21. Findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pusations, 5 cm above the sternal angle when the head of his bed is eleveted 45°. The FNP knows that this finding indicate:

a. Decreased fluid volume.

b. Increased cardiac output.

c. Narrowing of jugular veins.

d. Elevated pressure related to heart failure.

22. The component of the conduction system referred to as the pacemaker of the heart is the

a. Atrioventricular (AV) node.

b. Sinoatrial (SA) node.

c. Bundle of His.

d. Bundle branches.

23. The FNP is reviewing anatomy and physiology of the heart. Which statement best describes by atrial kick?

a. The atria contract during systole and attempt to push against closed valves.

b. Contraction of the atria at the beginning of diastole can be felt as a palpitation.

c. Atrial kick is the pressure exerted against the atria as the ventricles contract during systole.

d. The atria contract toward the end of diastole and push the remaining blood into the ventricles.

24. A 45-year-old man is in the clinic for a routine physical. During history the patient states he has been having difficulty sleeping. I’ll be sleeping great and then I wake up and feel like I can’t catch my breath. The FNP‘s best response to this would be

a. “When was your last electrocardiogram?”

b. “It’s probably because it’s been so hot at night.”

c. “Do you have any history of problems with your heart?”

d. “Have you had a recent sinus infection or upper respiratory infection?”

25. When assessing a patient the FNP notes that the left femoral pulse as diminished 1 /4 . What should the FNP do next?

Auscultate the site for a bruit.

MN568 Unit 10

Which statement about confusion is true?

Question options:

a) Confusion is a disease process.

b) Confusion is always temporary.

c) Age is a reliable predictor of confusion.

d) Polypharmacy is a major contributor to confusion in older adults.

Question 2 0 / 2 points

Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Question options:

a) Meclizine

b) Diphenhydramine

c) Diamox

d) Promethazine

Question 3 2 / 2 points

The hallmark of an absence seizure is:

Question options:

a) No activity at all

b) A blank stare

c) Urine is usually voided involuntarily

d) The attack usually lasts several minutes

Question 4 2 / 2 points

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

Question options:

a) Every 3 months

b) Every 6 months

c) Annually

d) Whenever there is a problem

Question 5 2 / 2 points

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

Question options:

a) A teenage male

b) A 65-year-old male

c) A 25-year-old female

d) A 60-year-old female

Question 6 2 / 2 points

Which of the following is a specific test to MS?

Question options:

a) Magnetic resonance imaging (MRI)

b) Computed tomography (CT) scan

c) A lumbar puncture

d) There is no specific test.

Question 7 2 / 2 points

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

Question options:

a) Cholinesterase inhibitors

b) Anxiolytics

c) Antidepressants

d) Atypical antipsychotics

Question 8 2 / 2 points

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

Question options:

a) Epidural hematoma

b) Subdural hematoma

c) Subarachnoid hematoma

d) Intraparenchymal hemorrhage

Question 9 2 / 2 points

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

Question options:

a) CN V

b) CN VII

c) CN IX

d) CN X

Question 10 2 / 2 points

Which statement best describes a carotid bruit?

Question options:

a) It is felt with the middle three fingers over the carotid artery.

b) A bruit becomes audible when the lumen is narrowed to 1 mm or less.

c) A low-pitched bruit is a medical emergency.

d) The higher the pitch of the bruit, the higher the degree of stenosis.

Question 11 2 / 2 points

Which patient is more likely to have a cluster headache?

Question options:

a) A female in her reproductive years

b) A 40-year-old African American male

c) A 55-year-old female who drinks 10 cups of coffee daily

d) A 45-year-old male awakened at night

Question 12 2 / 2 points

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

Question options:

a) Dementia

b) Alzheimer’s disease

c) Parkinson’s disease

d) Delirium

Question 13 2 / 2 points

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

Question options:

a) Purulent meningitis

b) Chronic meningitis

c) Aseptic meningitis

d) Herpes meningitis

Question 14 2 / 2 points

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

Question options:

a) MRI

b) CT

c) Electroencephalogram (EEG)

d) An initial lumbar puncture

Question 15 2 / 2 points

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

Question options:

a) A stabbing pain on one small area of the body

b) A vesicular skin lesion on one side of the body

c) A pain that is worse upon awakening

d) A lesion on the exterior ear canal

Question 16 1 / 1 point

Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

Question options:

a) “Most patients have complete recovery in 3 to 6 months.”

b) “Unfortunately, you’ll probably have a small amount of residual damage.”

c) “Don’t worry, I’ll take care of everything.”

d) “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 17 2 / 2 points

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

Question options:

a) “L-dopa is neuroprotective.”

b) “The primary goal of therapy is to replace depleted stores of dopamine.”

c) “This is the only drug that can provide symptomatic benefit.”

d) “This is the initial monotherapy drug.”

Question 18 2 / 2 points

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

Question options:

a) Resting tremor

b) Bradykinesia

c) Rigidity

d) Postural instability

Question 19 2 / 2 points

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

Question options:

a) Light sensitivity

b) Pulsatile pain

c) Sound sensitivity

d) Experiencing an aura

Question 20 2 / 2 points

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

Question options:

a) The duration of central vertigo is shorter than that of peripheral vertigo.

b) There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.

c) Central vertigo is positional, and peripheral vertigo is not.

d) The onset of central vertigo is more sudden than that of peripheral vertigo.

Question 21 2 / 2 points

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

Question options:

a) Greater than 25%

b) Greater than 50%

c) Greater than 75%

d) Only for 100% occlusion

Question 22 2 / 2 points

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

Question options:

a) Aspirin

b) Ticlopidine

c) Clopidogrel

d) Aspirin and clopidogrel

Question 23 2 / 2 points

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

Question options:

a) MRI

b) CT

c) Cerebrospinal fluid analysis

d) EEG

Question 24 2 / 2 points

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

Question options:

a) Sam-e

b) Saint John’s Wort

c) Melatonin

d) Saw Palmetto

Question 25 0 / 2 points

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

Question options:

a) Asking the patient to unravel a Rubik’s cube

b) Determining if the patient can drive on the highway

c) Asking the patient about a news event from the current week

d) Seeing if the patient can keep his or her home clean

Question 26 2 / 2 points

About 90% of all headaches are?

Question options:

a) Tension

b) Migraine

c) Cluster

d) Without pathological cause

Question 27 2 / 2 points

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

Question options:

a) Once diagnosed with a seizure disorder, patients must never drive again.

b) After being seizure free for 6 months, patients may drive.

c) Each state has different laws governing driving for individuals with a seizure disorder.

d) These persons may drive but never alone.

Question 28 2 / 2 points

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

Question options:

a) Glatiramer acetate

b) Natalizumab

c) Fingolimod

d) Glucocorticoids

Question 29 2 / 2 points

The ‘freezing phenomenon’ is a cardinal feature of?

Question options:

a) Parkinson’s disease

b) Alzheimer’s disease

c) A CVA

d) Bell’s palsy

Question 30 2 / 2 points

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

Question options:

a) Spinothalamic dysfunction

b) Ratcheting

c) Cogwheeling

d) Hand tremors

Question 31 2 / 2 points

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

Question options:

a) Guillain-Barré syndrome

b) Parkinson’s disease

c) Alzheimer’s disease

d) Huntington’s disease

Question 32 1 / 1 point

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

Question options:

a) Guillain-Barré syndrome

b) Parkinson’s disease

c) Alzheimer’s disease

d) Delirium

Question 33 2 / 2 points

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

Question options:

a) SLUMS

b) MoCA

c) FAST

d) MMSE

Question 34 2 / 2 points

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

Question options:

a) 1 hour

b) 3 hours

c) 6 hours

d) 12 hours

Question 35 2 / 2 points

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

Question options:

a) Tension

b) Migraine

c) Cluster

d) Stress

Question 36 2 / 2 points

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

Question options:

a) Acetylcholine

b) Gamma-aminobutyric acid (GABA)

c) Dopamine

d) Serotonin

Question 37 2 / 2 points

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

Question options:

a) 1 month

b) 3 months

c) 6 months

d) 12 months

Question 38 1 / 1 point

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

Question options:

a) Pheochromocytoma

b) Hyperthyroidism

c) Cardiac arrhythmias

d) All of the above

Question 39 2 / 2 points

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

Question options:

a) Benzodiazepines

b) Selective serotonin reuptake inhibitors (SSRIs)

c) Tricyclic antidepressants

d) Cognitive behavioral therapy

Question 40 1 / 1 point

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

Question options:

a) Hypersomnolence

b) Blunted feelings

c) Loss of interest in significant activities

d) Intrusive recurrent recollections of the event

Question 41 2 / 2 points

Which of the following neuroendocrine abnormalities is implicated in depression?

Question options:

a) Decrease in adrenal size

b) Increased cortisol and corticotrophin-releasing hormone

c) An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone

d) Increased inhibitory response of glucocorticoids to dexamethasone

Question 42 2 / 2 points

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

Question options:

a) SSRIs are more effective than TCAs.

b) SSRIs take less time to work than TCAs.

c) SSRIs have a more favorable side-effect profile than TCAs.

d) SSRIs are not lethal in overdose.

Question 43 2 / 2 points

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

Question options:

a) 2 weeks

b) 3 weeks

c) 4 weeks

d) 5 weeks

Question 44 2 / 2 points

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

Question options:

a) Before the initiation of treatment

b) 1 to 2 weeks after the initiation of treatment

c) When switching to a different medication

d) 1 to 2 weeks after tapering off medications

Question 45 2 / 2 points

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

Question options:

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

b) Switch the patient to a different antipsychotic.

c) Treat the patient with anticholinergics.

d) Treat the patient with anticonvulsants.

Question 46 1 / 1 point

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

Question options:

a) Anger, denial, depression, bargaining, acceptance

b) Anger, denial, bargaining, acceptance, depression

c) Denial, anger, depression, bargaining, acceptance

d) Denial, anger, bargaining, depression, acceptance

Question 47 1 / 1 point

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

Question options:

a) Memory impairment

b) Sexual dysfunction

c) Dry mouth

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

Question 48 2 / 2 points

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

Question options:

a) GABA

b) Acetylcholine

c) Dopamine

d) Serotonin

Question 49 2 / 2 points

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

Question options:

a) 0.05

b) 0.1

c) 0.2

d) 0.3

Question 50 2 / 2 points

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

Question options:

a) Every 30 minutes

b) Every 60 minutes

c) Every 90 minutes

d) Every 180 minutes

Question 51 2 / 2 points

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

Question options:

a) Hypercholesterolemia

b) Hypermagnesmia

c) Leukocytosis

d) Decreased TRH

Question 52 2 / 2 points

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

Question options:

a) Sertraline

b) Fluoxetine

c) Citoprolam

d) Imipramine

Question 53 2 / 2 points

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

Question options:

a) Liver function

b) Vision

c) Growth parameters

d) Renal function

Question 54 2 / 2 points

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

Question options:

a) Depression

b) Obsessive-compulsive disorder

c) Substance abuse

d) PTSD

Question 55 2 / 2 points

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

Question options:

a) 2 weeks

b) 1 month

c) 3 months

d) 6 months

Question 56 2 / 2 points

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

Question options:

a) Depression

b) Anxiety

c) Substance-related addictions

d) Gambling

Question 57 1 / 1 point

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

Question options:

a) Clinical disorder or focus of clinical attention

b) Personality or environmental problems

c) Environmental and psychosocial stressors

d) Global assessment of functioning

Question 58 2 / 2 points

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

Question options:

a) CAGE

b) SANE

c) SAD PERSONAS

d) DIGFAST

Question 59 2 / 2 points

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

Question options:

a) ADHD

b) Bipolar

c) Depression

d) Anxiety

Question 60 1 / 1 point

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

Question options:

a) Substance abuse and medication effects

b) Medical and neurological disorders

c) Cluster B personality disorders and depression

d) Obsessive-compulsive disorder

Question 61 1 / 1 point

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

Question options:

a) True

b) False

Question 62 1 / 1 point

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

Question options:

a) True

b) False

Question 63 1 / 1 point

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

Question options:

a) True

b) False

Question 64 1 / 1 point

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

Question options:

a) True

b) False

Question 65 1 / 1 point

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

Question options:

a) True

b) False

Question 66 1 / 1 point

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

Question options:

a) True

b) False

Question 67 1 / 1 point

A no-suicide contract can prevent a suicide attempt.

Question options:

a) True

b) False

Question 68 1 / 1 point

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

Question options:

a) True

b) False

Question 69 1 / 1 point

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

Question options:

a) True

b) False

Question 70 1 / 1 point

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

Question options:

a) True

b) False

Question 71 1 / 1 point

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

Question options:

a) Human papillomavirus (HPV)

b) Endometrial hyperplasia

c) Vagismus

d) Polycystic ovarian syndrome

Question 72 2 / 2 points

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

Question options:

a) Ceftriaxone

b) Doxycycline

c) Acyclovir

d) Metronidazole

Question 73 1 / 1 point

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

Question options:

a) Gonorrhea

b) HPV

c) Chlamydia

d) Trichomonas

Question 74 1 / 1 point

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

Question options:

a) Trichomonas

b) Bacterial vaginosis

c) HPV

d) Herpes simplex virus

Question 75 2 / 2 points

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

Question options:

a) Metronidazole

b) Ceftriaxone

c) Diflucan

d) Doxycycline

Question 76 1 / 1 point

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

Question options:

a) Fluconazole

b) Estrogen vaginal cream

c) Metronidazole

d) Doxycycline

Question 77 2 / 2 points

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

Question options:

a) Filiform/digitate wart

b) Dysplastic cervical lesion

c) Condyloma acuminata

d) Koilocytosis

Question 78 0 / 2 points

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

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 79 2 / 2 points

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

Question options:

a) Necrotizing fasciitis

b) Periorbital cellulitis

c) Erysipelas

d) “Flesh-eating” cellulitis

Question 80 2 / 2 points

The forced vital capacity is decreased in:

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) Restrictive disease

Question 81 2 / 2 points

The most common cause of CAP is?

Question options:

a) Streptococcus pneumoniae

b) Klebsiella pneumoniae

c) Legionella pneumoniae

d) Pseudomonas aeruginosa

Question 82 2 / 2 points

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

Question options:

a) Asthma

b) Increased white blood cells

c) Insulin resistance

d) Hyperactivity

Question 83 2 / 2 points

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

Question options:

a) IgA

b) IgE

c) IgG

d) IgM

Question 84 2 / 2 points

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

Question options:

a) The scrotum will be dark.

b) The scrotum will appear light pink or yellow.

c) The scrotum will appear milky white.

d) The internal structures will be clearly visible.

Question 85 0 / 2 points

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

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 86 2 / 2 points

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

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 87 1 / 1 point

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

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 88 1 / 1 point

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

Question options:

a) Testicular cancer

b) Inguinal hernia

c) Varicocele

d) All of the above

Question 89 1 / 1 point

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

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 90 1 / 1 point

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

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 91 2 / 2 points

Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

Question options:

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

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

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

d) “We’ll have to do some tests.”

Question 92 2 / 2 points

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

Question options:

a) An ulcer

b) A fissure

c) Lichenification

d) An excoriation

Question 93 2 / 2 points

A bulla is:

Question options:

a) A vesicle larger than 1 cm in diameter

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

c) A superficial elevated lesion filled with purulent fluid

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

Question 94 1 / 1 point

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

Question options:

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

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

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

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

Question 95 1 / 1 point

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 96 1 / 1 point

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

Question options:

a) True

b) False

Question 97 2 / 2 points

Which of the following medications can cause hyperglycemia?

Question options:

a) Prednisone

b) Metformin

c) Synthroid

d) Cephalexin

Question 98 2 / 2 points

Which of the following is diagnostic for diabetes mellitus?

Question options:

a) A1C 7.0 on one occasion

b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions

c) Random glucose of 200 mg/dL on two occasions

d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 99 2 / 2 points

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

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 100 1 / 1 point

A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis?

Question options:

a) Anxiety disorder

b) Pheochromocytoma

c) Psychosis

d) All of the above

Stakeholder Engagement

Chapter 9 discussed the importance of stakeholder engagement in policy making. The author presented several benefits and an analysis of five cases in which stakeholder engagement added value to the policy making process.

If you were leading a project to develop a comprehensive policy for managing pedestrian traffic flow in a popular downtown metropolitan district, what measures would you take to engage stakeholders in that project? Your answer should outline your suggestions and clearly explain why each one would add value.