Advanced Pathophysiology for Primary Care Exam Bank
Course Introduction
Advanced Pathophysiology for Primary Care provides an in-depth exploration of the physiological and pathological mechanisms underlying diseases commonly encountered in primary care settings. This course emphasizes the integration of cellular and systems-level understanding as they relate to clinical manifestations, disease progression, and patient outcomes. Through case studies and evidence-based resources, students will analyze alterations in normal physiology related to genetics, immunological responses, inflammation, infection, and chronic conditions across the lifespan. The course prepares healthcare professionals to apply pathophysiological principles in developing clinical reasoning and supporting diagnostic and therapeutic decisions for diverse populations in primary care.
Recommended Textbook
Primary Care Art and Science of Advanced Practice Nursing 4th Edition by Dunphy
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Page 2
Chapter 3: Health Promotion
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Sample Questions
Q1) Prevalence is the number of new cases of a particular disease.
A)True
B)False
Answer: False
Q2) Endemic is the term used when the presence of an event is constant.
A)True
B)False Answer: True
Q3) Which of the following is an example of secondary prevention in a 50-year-old woman?
A)Yearly mammogram
B)Low animal fat diet
C)Use of seat belt
D)Daily application of sunscreen
Answer: A
Q4) The "bird" flu of 2005 to 2006 is considered a sporadic outbreak.
A)True
B)False Answer: False
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Chapter 5: Evidence-Based Care
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Sample Questions
Q1) Which of the following would be considered the research design for Level III evidence?
A)Well-designed controlled trials without randomization
B)Systematic reviews of descriptive or qualitative studies
C)Systematic review of randomized clinical trial studies
D)Opinion of authorities and expert committees
Q2) Which of the following would be considered the research design for Level VII evidence?
A)Well-designed controlled trials without randomization
B)Opinion of authorities and expert committees
C)Well-designed case control or cohort studies
D)Single descriptive or qualitative study .
Q3) Which of the following is a crucial element of developing a guideline?
A)Creating a physician expert panel
B)Reviewing the literature with ratings of available evidence
C)Conducting an external review of a guideline
D)Developing evidence-based tables
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4
Chapter 6: Neurological Problems
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Sample Questions
Q1) About 90% of all headaches are?
A)Tension
B)Migraine
C)Cluster
D)Without pathological cause
Q2) Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?
A)Guillain-Barre syndrome
B)Parkinson's disease
C)Alzheimer's disease
D)Delirium
Q3) What antiplatelet agent is most widely used for secondary prevention of stroke?
A)Aspirin
B)Ticlopidine
C)Clopidogrel
D)Aspirin and clopidogrel
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Page 5
Chapter 7: Skin Problems
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Sample Questions
Q1) Why do people of African descent have a lower incidence of non-melanoma skin cancer?
A)They have an increased number of melanocytes.
B)Their darker skin protects from ultraviolet radiation.
C)Their skin is thicker.
D)Their immune system is stronger.
Q2) Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?
A)Keratosis pilaris
B)Dennie's sign
C)Keratoconus
D)Pityriasis alba
Q3) Which statement regarding necrotizing fasciitis is true?
A)The hallmark of this infection is its slow and steady progression.
B)Once the border of the infection is "established," it does not spread.
C)Loss of life or limb is a potential complication.
D)The lesion is most dangerous, because it is painless.
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Chapter 8: Eyes, Ears, Nose, and Throat
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Sample Questions
Q1) Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?
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.
Q2) 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?
A)Gonorrhea
B)Mononucleosis
C)Influenza
D)Herpes zoster
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Chapter 9: Respiratory Problems
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Sample Questions
Q1) Most nosocomial pneumonias are caused by:
A)Fungi
B)Viruses
C)Gram-negative bacteria
D)Pneumococcal pneumonia
Q2) Which ethnic group has the highest lung cancer incidence and mortality rates?
A)African American men
B)Scandinavian men and women
C)Caucasian women
D)Asian men .
Q3) Which information should be included when you are teaching your patient about the use of nicotine gum?
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.
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8
Chapter 10: Cardiovascular Problems
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Sample Questions
Q1) Which ECG change is typical of cardiac ischemia?
A)T-wave inversion
B)ST-segment elevation
C)Significant Q wave
D)U-wave
Q2) Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
A)Severe asthma
B)A common valvular lesion
C)Severe hypertension
D)A prosthetic heart valve
Q3) You just started Martha on HTN therapy.The Eighth Joint National Committee recommends that if her goal BP is not reached in what length of time, you should increase the initial drug or add a second drug to it?
A)1 month
B)3 months
C)6 months
D)1 year .
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9
Chapter 11: Abdominal Problems
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Sample Questions
Q1) Which of the following is most effective in diagnosing appendicitis?
A)History and physical
B)Sedimentation rate
C)Kidney, ureter, and bladder x-ray
D)Complete blood count (CBC) with differentials
Q2) A 45-year-old patient presents with a chief complaint of generalized abdominal pain.Her physical examination is remarkable for left lower quadrant tenderness.At this time, which of the following should be considered in the differential diagnosis?
A)Endometriosis
B)Colon cancer
C)Diverticulitis
D)All of the above
Q3) A patient is seen in the clinic with right upper quadrant pain that is radiating to the middle of the back.The NP suspects acute cholelithiasis.The NP should expect which of the following laboratory findings?
A)Decreased alanine aminotransferase and decreased aspartate aminotransferase
B)Elevated alkaline phosphatase
C)Elevated indirect bilirubin
D)Decreased white blood cells
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Page 10
Chapter 12: Renal Problems
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Sample Questions
Q1) A patient is seen in the clinic and diagnosed with Stage I renal cancer.The provider should refer the patient to a nephrologist for which of these treatments?
A)Chemotherapy
B)Nephrectomy
C)Palliative treatment
D)Radiation
Q2) Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI?
A)Last menstrual period
B)Method of birth control
C)Last unprotected sexual contact
D)All of the above
Q3) A 30-year-old patient presents with pain on urination.The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites.What is the probable diagnosis?
A)Lower urinary tract infection
B)Chlamydia infection
C)Candidiasis
D)Pyelonephritis
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Chapter 13: Mens Health Problems
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Sample Questions
Q1) Hepatitis A is considered a sexually transmitted infection by the Centers for Disease Control and Prevention.
A)True
B)False
Q2) What is the treatment of choice for a patient diagnosed with testicular cancer?
A)Radical orchidectomy
B)Lumpectomy
C)Radiation implants
D)All of the above
Q3) A 14-year-old male is seen with complaints of severe testicular pain.The clinician suspects testicular torsion.Which of the following is the appropriate action?
A)Refer to a urologist immediately.
B)Obtain a computed tomography (CT) scan.
C)Instruct the patient to elevate the scrotum.
D)Prescribe ibuprofen.
Q4) Patients treated for Neisseria gonorrhoeae also should be treated for Chlamydia trachomatis.
A)True
B)False
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Chapter 14: Womens Health Problems
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Sample Questions
Q1) A 22-year-old woman is diagnosed with premenstrual syndrome.Which of the following lifestyle changes should the clinician suggest to help minimize the patient's symptoms?
A)At least 4 cups of green tea daily
B)Regular exercise
C)Take vitamin A supplements
D)Eat a diet high in iron
Q2) Most breast cancer cases are in women with a family history of breast cancer. A)True
B)False
Q3) A 45-year-old woman is seen because of irregular menstrual periods.Her follicle-stimulating hormone (FSH) level is 48 mIU/mL, and her luteinizing hormone (LH) level is elevated.She asks the clinician what this means.Which would be the best response?
A)"You are approaching menopause."
B)"You have a hormonal imbalance."
C)"Your FSH is normal, but your pituitary is making too much LH."
D)"There is an imbalance between your ovaries and pituitary."
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Chapter 15: Musculoskeletal Problems
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Sample Questions
Q1) Mrs.Allen is a 60-year-old woman who has been diagnosed with osteoporosis.She is very concerned about the risk of breast cancer associated with hormone replacement therapy and is wondering what other treatments are available to her.The clinician explains that bisphosphonates are another class of drugs used in the prevention and treatment of osteoporosis.What teaching should the clinician give Mrs.Allen in regard to taking bisphosphonates?
A)Taking bisphosphonates can result in hypercalcemia, so calcium intake should be decreased while taking this class of drugs.
B)There is potential for upper GI irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying.
C)This class of drugs can be taken at any time of the day without regard to meals.
D)None of the above
Q2) The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.
A)True
B)False
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Chapter 16: Endocrinemetabolic Problems
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Sample Questions
Q1) A patient with type 2 diabetes asks the clinician why she needs to exercise.In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes?
A)Reduces postprandial blood glucose
B)Reduces triglycerides and increases high-density lipoprotein (HDL)
C)Reduces total cholesterol
D)All of the above
Q2) Urine-free cortisol is one of four diagnostic tests recommended for Cushing's syndrome.
A)True
B)False
Q3) A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months.On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes.Which of the following tests should be ordered next?
A)Serum calcium
B)TSH
C)Electrolytes
D)Urine specific gravity
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Page 15
Chapter 17: Hematologic and Immune Problems
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Sample Questions
Q1) Which type of the following is characterized by fatigue on awakening that may improve with exercise?
A)Functional fatigue
B)Fatigue with an organic origin
C)Fatigue of chronic anemia
D)Fatigue of depression and anxiety
Q2) Reuben, age 24, has HIV and just had a routine viral load test done.The results show a falling viral load.What does this indicate?
A)A favorable prognostic trend
B)Disease progression
C)The need to be more aggressive with Reuben's medications
D)The eradication of the HIV
Q3) An important complication of antiretroviral (ARV) therapy in patients with advanced AIDS is which of the following?
A)Immune reconstitution inflammatory syndrome
B)Improvement in opportunistic infections
C)Restoration of immune system to preinfection status
D)Progression to AIDS
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16
Chapter 18: Psychosocial Problems
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Sample Questions
Q1) After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?
A)2 weeks
B)3 weeks
C)4 weeks
D)5 weeks
Q2) When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects.
A)True
B)False
Q3) Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)?
A)Liver function
B)Vision
C)Growth parameters
D)Renal function
Q4) Adults must show childhood onset of symptoms to receive a diagnosis of ADHD.
A)True
B)False
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Chapter 19: Emergency Problems
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Sample Questions
Q1) In the epithelialization phase of wound healing, the wound will have only what percent of its normal tensile strength at 3 weeks?
A)Less than 15%
B)15% to 20%
C)25% to 40%
D)Greater than 50%
Q2) Cerebellar function may be assessed by performing which examination/test?
A)Gag reflex
B)Pupillary response
C)Romberg's test
D)Apley's test
Q3) Cerebrospinal fluid (CSF) may leak through the cribriform plate region of the skull following a head injury and cause which of the following?
A)Ear CSF otorrhea
B)Leakage of CSF from the eye
C)Nasal CSF rhinorrhea
D)Leakage of CSF from the mouth
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18
Chapter 20: Palliative Care
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Sample Questions
Q1) A 75-year-old man is being treated as an outpatient for metastatic prostate cancer.Which of the following statements is true regarding the management of pain with opioids in the elderly?
A)Opioids with a long half-life, such as methadone, are a good choice, because they stay in the system longer, and patients do not have to remember to take multiple pills.
B)Serum creatinine is the best measurement of renal function in the elderly and should be done prior to the initiation of treatment with opioids.
C)Renal clearance of medications is faster in the elderly, so higher dosages of medications are needed to adequately control pain.
D)None of the above
Q2) Oxygen has shown no benefit in alleviating dyspnea in patients without hypoxemia. A)True
B)False
Q3) Some anticonvulsant drugs can be used as an adjuvant treatment for mild pain.
A)True
B)False
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Chapter 21: Ethical and Legal Issues of a Caring-Based Practice
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Sample Questions
Q1) The Joint Commission mandates that all health-care organizations have:
A)A mechanism in place for the consideration of ethical issues
B)An Ethics committee
C)A resident parish nurse
D)Legal counsel who is knowledgeable about ethics
Q2) Which type of liability insurance covers only situations in which the incident occurred and the claim was made while the policy was in effect?
A)Claims made policy
B)Occurrence policy
C)An employment coverage policy
D)A "tail" policy
Q3) Which ethical principle reflects respect for all persons and their self-determination?
A)Autonomy
B)Beneficence
C)Justice
D)Veracity
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Chapter 22: Business of Advanced Practice
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Sample Questions
Q1) Current procedural terminology (CPT) coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners.Clinicians are paid based on calculated resource costs that, in turn, are based on practice components.Which of the following is a part of the components used to calculate the per CPT code payment rate?
A)Clinician education loans
B)Clinician practice liability and malpractice expense
C)Clinician reported cost reduction efforts
D)Clinician volume of patients treated
Q2) Medicare benefits were offered to U.S.beneficiaries beginning in 1965.What was the service added with the Medicare D plan in 2006?
A)Health-care screening
B)Health-care education
C)Pharmaceutical coverage
D)Durable medical equipment coverage
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21
Chapter 23: The 15-Minute Hour
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Sample Questions
Q1) The BATHE technique was developed more than 20 years ago and has been used extensively in primary care and family practice.The new 'Positive BATHE' stresses:
A)A belief that all things are possible through positive affirmations
B)A belief that one should only refer to practitioners who embrace the viewpoint of positive psychology
C)Personal accomplishment, thankfulness, autonomy, and general positive effect
D)The patient's problems and concerns
Q2) Which is not a basic principle of MI?
A)People often continue behaviors with negative consequences for reasons unknown to the provider.
B)The patient is the expert on his/her behavior.
C)Providers are obligated to inform each patient of the negative consequences of their behaviors.
D)Helping patients understand ambivalence for change is often more powerful than direct instruction.
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22
Chapter 24: Putting Caring Into Practice: Caring for Self
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Q1) Patsy, a 42-year-old experienced APRN, is orienting a new APRN to the Minute Clinic, where she has worked for more than 5 years.Patsy loves her work and was concerned when the new APRN, Sue, expressed her dissatisfaction with this setting."I hate the idea of being here on my own, with no back-up and support after orientation" was one of Sue's concerns.Sue confessed that this was the only job she could find.Patsy felt good in her independent role and felt she had worked to create a positive atmosphere for her patients at all times.She derived joy and satisfaction from her ability to do this for her patients.Patsy found Sue's endless complaints debilitating.Patsy demonstrated resiliency by using which of the following strategies?
A)Patsy distanced Sue by listening to her as little as possible.
B)Patsy openly shared her positive feelings about the work environment and took a risk by sharing with Sue that she found her endless complaining draining.
C)Patsy spoke privately with their supervisor, Pamela, stating that she did not think Sue could be successful in this environment.
D)Patsy requested that Sue be assigned to a different APRN for orientation.
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