NP NP Diagnosis & Clinical Decision-Making 2

Question 1

A 40-year-old woman presents with fatigue, weight gain, cold intolerance, constipation, and dry skin. TSH is elevated at 9.2 mIU/L with low free T4. The diagnosis is:

Accepted Answer

Primary hypothyroidism

Answer

Hyperthyroidism

Answer

Subclinical hyperthyroidism

Answer

Secondary hypothyroidism

Question 2

A patient presents with a painful, well-demarcated, erythematous rash with vesicles following a dermatomal distribution on the right flank. The NP diagnoses:

Accepted Answer

Herpes zoster (shingles)

Answer

Contact dermatitis

Answer

Cellulitis

Answer

Impetigo

Question 3

A 60-year-old male reports rectal bleeding, change in bowel habits, and a 20-pound weight loss over three months. The NP's highest-priority action is:

Accepted Answer

Order urgent colonoscopy to rule out colorectal cancer

Answer

Recommend dietary fiber and reassess in 3 months

Answer

Prescribe topical hemorrhoid treatment

Answer

Order H. pylori testing

Question 4

A patient presents with unilateral leg swelling, warmth, and redness after a long flight. Duplex ultrasound is ordered to evaluate for:

Accepted Answer

Deep vein thrombosis (DVT)

Answer

Peripheral artery disease

Answer

Superficial thrombophlebitis

Answer

Lymphedema

Question 5

Which finding on a knee examination is most consistent with an anterior cruciate ligament (ACL) tear?

Accepted Answer

Positive Lachman test with loss of firm endpoint

Answer

Positive McMurray test

Answer

Positive patellar apprehension test

Answer

Positive valgus stress test at 30 degrees

Question 6

A urine pregnancy test is positive and the patient has severe lower abdominal pain, shoulder pain, and vaginal spotting. The NP should immediately suspect:

Accepted Answer

Ectopic pregnancy

Answer

Threatened abortion

Answer

Ovarian cyst rupture

Answer

Appendicitis