KAPLAN MN568 2018 March Unit 2 Exam Latest

MN568   Primary Care Across the Span

Unit 2 Exam

Question 1                         

Which of the following statements regarding TST is true?

Question options:

a)            Tests should be read 48 hours after the injection.

 

b)            The size of the TST reaction has nothing to do with erythema but is based solely on induration.

 

 

c)            It is a type V T cell-mediated immune response.

 

 

d)            The diameter of the induration is measured in centimeters.

 

Question 2                         

Julie has a postnasal drip along with her cough. You assess her for:

Question options:

 

a)            Asthma

 

 

b)            Sinusitis

 

 

c)            Allergic or vasomotor rhinitis

 

 

d)            Influenza

 

Question 3                         

Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:

Question options:

 

a)            4 weeks

 

 

b)            8 weeks

 

 

c)            12 weeks

 

 

d)            16 weeks

 

Question 4                         

Which obstructive lung disease is classified as reversible?

Question options:

 

a)            Asthma

 

 

b)            Chronic bronchitis

 

 

c)            Emphysema

 

 

d)            COPD

 

Question 5                         

Which of the following medications used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape?

Question options:

 

a)            Pilocarpine

 

 

b)            Timolol

 

 

c)            Brinzolamide

 

 

d)            Acetazolamide

 

Question 6                         

Most nosocomial pneumonias are caused by:

Question options:

 

a)            Fungi

 

 

b)            Viruses

 

 

c)            Gram-negative bacteria

 

 

d)            Pneumococcal pneumonia

 

Question 7                         

A chronic cough lasts longer than:

Question options:

 

a)            3 weeks

 

 

b)            1 month

 

 

c)            6 months

 

 

d)            8 weeks

 

Question 8                         

African American patients seem to have a negative reaction to which of the following asthma medications?

Question options:

 

a)            Inhaled corticosteroids

 

 

b)            Long-term beta-agonist bronchodilators

 

 

c)            Leukotriene receptor agonists

 

 

d)            Oral corticosteroids

 

Question 9                         

Which of the following is an example of sensorineural hearing loss?

Question options:

 

a)            Perforation of the tympanic membrane

 

 

b)            Otosclerosis

 

 

c)            Cholesteatoma

 

 

d)            Presbycusis

 

Question 10                       

Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?

Question options:

 

a)            The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated.

 

 

b)            The cancer is in situ; it is spreading into the lymph nodes, but the spread cannot be evaluated otherwise.

 

 

c)            The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.

 

 

d)            The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading.

 

Question 11                       

Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?

Question options:

 

a)            The body converts bilberry to vitamin A, which helps to maintain a healthy lens.

 

 

b)            Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes.

 

 

c)            Bilberry boosts oxygen and blood delivery to the eye.

 

 

d)            Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs.

 

Question 12                       

Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course?

Question options:

 

a)            Nuclear cataracts

 

 

b)            Cortical cataracts

 

 

c)            Posterior cataracts

 

 

d)            Immature cataracts

 

Question 13                       

Which information should be included when you are teaching your patient about the use of nicotine gum?

Question options:

 

a)            The gum must be correctly chewed to a softened state and then placed in the buccal mucosa.

 

 

b)            Patients should not eat for 30 minutes prior to or during the use of the gum.

 

 

c)            Initially, one piece is chewed every 30 minutes while awake.

 

 

d)            Acidic foods and beverages should be encouraged during nicotine therapy.

 

Question 14                       

The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?

Question options:

 

a)            Viral conjunctivitis

 

 

b)            Keratoconjunctivitis

 

 

c)            Bacterial conjunctivitis

 

 

d)            Allergic conjunctivitis

 

Question 15                       

A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause?

Question options:

 

a)            Gonorrhea

 

 

b)            Mononucleosis

 

 

c)            Influenza

 

 

d)            Herpes zoster

 

Question 16                       

Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking?

Question options:

 

a)            Inhaled corticosteroid

 

 

b)            Leukotriene receptor antagonist

 

 

c)            Systemic corticosteroid

 

 

d)            Methyl xanthenes

 

Question 17                       

-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis??What is the first-line recommended treatment against Group A

Question options:

 

a)            Penicillin

 

 

b)            Quinolone

 

 

c)            Cephalosporin

 

 

d)            Macrolide

 

Question 18                       

Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?

Question options:

 

a)            He should stop smoking today.

 

 

b)            He should stop smoking tomorrow.

 

 

c)            His quit date should be in 1 week.

 

 

d)            He will be ready to quit after the first 30 days.

 

Question 19                       

A patient presents to the clinician with a sore throat, fever of 100.7ϒF, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

Question options:

 

a)            The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.

 

 

b)            Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.

 

 

c)            A throat culture should be performed to confirm the results of the rapid strep test.

 

 

d)            The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

 

Question 20                       

Why do you suspect that your patient may have a decreased response to the tuberculin skin test (TBT)?

Question options:

 

a)            She is on a high-protein diet.

 

 

b)            She is an adolescent.

 

 

c)            She has been on long-term corticosteroid therapy.

 

 

d)            She just got over a cold.

 

Question 21                       

The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection?

Question options:

 

a)            HSV type 2

 

 

b)            HIV

 

 

c)            Pneumonia

 

 

d)            Syphilis

 

Question 22                       

Which ethnic group has the highest lung cancer incidence and mortality rates?

Question options:

 

a)            African American men

 

 

b)            Scandinavian men and women

 

 

c)            Caucasian women

 

 

d)            Asian men

 

Question 23                       

Which type of stomatitis results in necrotic ulceration of the oral mucous membranes?

Question options:

 

a)            Vincent’s stomatitis

 

 

b)            Allergic stomatitis

 

 

c)            Apthous stomatitis

 

 

d)            Herpetic stomatitis

 

Question 24                       

Sam, age 78, presents to the clinic with respiratory symptoms. His pulmonary function tests are as follows: a normal total lung capacity, a decreased PaO2, and an increased PaCO2. On assessment, you auscultate coarse crackles and forced expiratory wheezes. What is your diagnosis?

Question options:

 

a)            Asthma

 

 

b)            Emphysema

 

 

c)            Chronic bronchitis

 

 

d)            Influenza

 

Question 25                       

The forced vital capacity is decreased in:

Question options:

 

a)            Asthma

 

 

b)            Chronic bronchitis

 

 

c)            Emphysema

 

 

d)            Restrictive disease

 

Question 26                       

A patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from:

Question options:

 

a)            Metoprolol

 

 

b)            Clopidogrel

 

 

c)            Tadalafil

 

 

d)            Captopril

 

Question 27                       

The most common cause of CAP is?

Question options:

 

a)            Streptococcus pneumoniae

 

 

b)            Klebsiella pneumoniae

 

 

c)            Legionella pneumoniae

 

 

d)            Pseudomonas aeruginosa

 

Question 28                       

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 29                       

Marci has been started on a tuberculosis (TB) regimen. Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically?

Question options:

 

a)            Pyridoxine

 

 

b)            Thiamine

 

 

c)            Probiotic

 

 

d)            Phytonadione

 

Question 30                       

In which of the following situations would referral to a specialist be needed for sinusitis?

Question options:

 

a)            Recurrent sinusitis

 

 

b)            Allergic sinusitis

 

 

c)            Sinusitis that is refractory to antibiotic therapy

 

 

d)            All of the above

 

Question 31                       

You are in the park playing with your children when you see that your friend is screaming for help. Her toddler has fallen and there is a stick lodged in his eye. The child is kicking and screaming and grabbing for the stick. You:

Question options:

 

a)            instruct his mother to hold him securely and not allow him to touch the stick, then carefully remove the stick from the eye.

 

 

b)            stabilize the foreign object and accompany the mother and child to the local ER.

 

 

c)            find a water fountain, hold the child to the water, and flush the eye.

 

 

d)            call 911.

 

Question 32                       

Nathan, a 32-year-old policeman, has a 15-pack-a-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do?

Question options:

 

a)            Hand him literature about smoking cessation at every visit.

 

 

b)            Wait until he is ready to talk to you about quitting.

 

 

c)            Document in the record that he is not ready to quit.

 

 

d)            Continue to ask him at every visit if he is ready to quit.

 

Question 33                       

Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD?

Question options:

 

a)            3 to 5 hours

 

 

b)            6 to 10 hours

 

 

c)            11 to 14 hours

 

 

d)            15 to 18 hours

 

Question 34                       

Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors?

Question options:

 

a)            He is a recovering alcoholic of 6 years.

 

 

b)            His collar size is 17 inches.

 

 

c)            He is the only person in his family who has this.

 

 

d)            He is extremely thin.

 

Question 35                       

The most significant precipitating event leading to otitis media with effusion is:

Question options:

 

a)            Pharyngitis

 

 

b)            Allergies

 

 

c)            Viral upper respiratory infection (URI)

 

 

d)            Perforation of the eardrum

 

Question 36                       

Severe pain associated with acute otitis media signifies perforation of the tympanic membrane.

Question options:

 

a)            True

 

 

b)            False.

 

Question 37                       

Which statement about adenocarcinoma of the lung is accurate?

Question options:

 

a)            It is the least common type of lung cancer, representing approximately 5% to 10% of cases.

 

 

b)            It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35% to 40% of all tumors.

 

 

c)            It is more common in men than in women and occurs almost entirely in cigarette smokers.

 

 

d)            It is aggressive, with rapid growth and early local and distant metastases via the lymphatic and blood vessels.

 

Question 38                       

Your patient states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead?

Question options:

 

a)            Fever

 

 

b)            Headache

 

 

c)            Exudative pharyngitis

 

 

d)            Rhinorrhea

 

Question 39                       

Marta is taking TB drugs prophylactically. How do you instruct her to take them?

Question options:

 

a)            Take them on an empty stomach to facilitate absorption.

 

 

b)            Take them with aspirin (ASA) to prevent flushing.

 

 

c)            Take them with ibuprofen to prevent a headache.

 

 

d)            Take them with food to prevent nausea.

 

Question 40                       

Which of the following conditions is associated with cigarette smoking?

Question options:

 

a)            Glaucoma

 

 

b)            Increased sperm quality

 

 

c)            Bladder cancer

 

 

d)            Eczema

 

Question 41                       

Cydney presents with a history of asthma. She has not been treated for a while. She complains of daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60% to 80% predicted. How would you classify her asthma severity?

Question options:

 

a)            Mild intermittent

 

 

b)            Mild persistent

 

 

c)            Moderate persistent

 

 

d)            Severe persistent

 

Question 42                       

As diabetic retinopathy progresses, the presence of ‘cotton wool’ spots can be detected. Cotton wool spots refer to:

Question options:

 

a)            Nerve fiber layer infarctions

 

 

b)            Blood vessel proliferation

 

 

c)            Venous beading

 

 

d)            Retinal hemorrhage

 

Question 43                       

Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens?

Question options:

 

a)            Coxsackievirus

 

 

b)            Cytomegalovirus

 

 

c)            Francisella tularensis

 

 

d)            Group A streptococcus

 

Question 44                       

Which of the following antibiotics provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected?

Question options:

 

a)            Penicillin V

 

 

b)            Amoxicillin

 

 

c)            Levofloxacin

 

 

d)            Clindamycin

 

Question 45                       

Which of the following statements regarding pulmonary function is true?

Question options:

 

a)            Cigarette smoking accelerates the decline in pulmonary function tenfold.

 

 

b)            Smoking cessation can reverse most pathological changes.

 

 

c)            Cigarette smoking decreases mucus production.

 

 

d)            There is a normal age-related decline in pulmonary function.

 

Question 46                       

Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis?

Question options:

 

a)            Vasomotor rhinitis

 

 

b)            Rhinitis medicamentosum

 

 

c)            Atrophic rhinitis

 

 

d)            Viral rhinitis

 

Question 47                       

The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient’s mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test?

Question options:

 

a)            Weber test

 

 

b)            Schwabach test

 

 

c)            Rinne test

 

 

d)            Auditory brainstem response (ABR) test

 

Question 48                       

An acutely presenting, erythematous, tender lump within the eyelid is called:

Question options:

 

a)            Blepharitis

 

 

b)            Hordeolum

 

 

c)            Chalazion

 

 

d)            Iritis

 

Question 49                       

You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?

Question options:

 

a)            “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”

 

 

b)            “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”

 

 

c)            “Drive to the emergency room now.”

 

 

d)            “Call 911.”

 

Question 50                       

You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?

Question options:

 

a)            Baker phenomenon

 

 

b)            Arnold reflex

 

 

c)            Cough reflex

 

 

d)            Tragus reflex