1. A patient presents with acute otitis externa with obstruction of the ear canal severe enough

• A patient presents with acute otitis externa with obstruction of the ear canal severe enough

to prevent patient self administration of pharmacologic treatment. What is the most effective means to administer topical agent solutions.

• Oral/systemic antibiotics
• Aural toileting or wicking or a combination of both
• A nebulizer machine
• Surgical debridement
• Otitis media, hypothyroid disease, deviated nasal septum, and chronic sinusitis are

differential diagnoses for what condition?

• Mumps
• Rhinitis
• Dental Abscess
• Viral influenza
• Which of the following would NOT be included as part of the focused SOAP note for a patient

who suffers from allergic rhinitis?

• Review of the HEENT physical examination
• Discussion of health promotion issues
• Patient Vital signs
• Referral for additional allergy testing

4.A patient diagnosed with bacterial conjunctivitis. Which of the following education and counseling notes would NOT be appropriate for this patient?

• Contact lenses should be discarded and new lenses should not be worn until symptoms

subside

• Clean all linens thoroughly
• Patient may return to work upon completing the initial dose of antibiotics
• Any eye make up should be replaced
• Incubation period for Group A beta-hemolytic streptococcus?
• 24-72 hours
• 12-24 hours

C. 72-96

D. +96

• Which of the following demographic groups would NOT be considered at risk for

complications of influenza?

• young children
• pregnant women
• Suffering from heart, kidney, or neurologic disease
• those who did not get the influenza vaccine

• A patient is diagnosed acute bronchitis. What is the most appropriate antibiotic treatment for

this patient?

• Penicillin
• Oflaxacin
• Metronidazol
• Antibiotics are not recommended
• According to the National Asthma education and prevention program (NAAEPP), which

treatment would be an example of a Step 1 preferred treatment for an adult with persistent asthma?

• Short acting beta 2 antagonist prn (SABA)
• Medium dose ICS and LABA
• low dose ICS and LABA
• high dose ICS and LABA and oral corticosteroid
• Which of the following would be appropriate in the plan for a patient diagnosed with COPD?
• Start HCTZ 12.5 mg daily. Discussed diet and exercise including review of DASH diet.
• Demonstrate proper use of inhalers. Discuss importance of influenza vaccine. Prescribed

albuterol. 2 puffs every 4 hrs prn for SOB

• Reviewed consequences of untreated condition. Encourage limited caloric intake to 1.800

daily. Prescribe lisinopril 1mg daily.

• Pt prescribed amoxicillin 500 mg po. Refrain from work or school until symptoms improve.
• Assessment findings include increased AP diameter, hypoxemia, expiratory wheezing,

cyanosis, chest tightness, and pursed lip breathing. Based on the symptoms presented what is the most likely diagnosis?

A. COPD

• Pharyngitis
• Hypertension
• Alpha thalassemia
• A 60 y/o white male has presented with HTN and no evidence of CKD or diabetes. According

to JNC 8 which of the following pharmacological interventions would be more appropriate?

• Betablocker such as acebutolol
• Nitroglycerine Spray PRN
• Hydrochlorothiazide
• High intensity statin
• At a 6 week follow up appt, a patient has not reached a goal to treat HTN with

hydrochlorothiazide, diet, and exercise. What would be an appropriate addition to the patient’s regimen?

• ACE or ARB
• aspirin
• surgical intervention

• increase in physical activity
• A 73 y/o female patient with both a personal and family history of HTN and CAD is suffering

from mild and intermittent chest pain. Using a direct risk factor assessment, what is the likely level of risk in this patient?

• High risk patient
• Intermediate risk patient
• Low risk patient
• Risk is unknown
• A patient presents with increased fatigue, persistent shortness of breath, lightheadedness

and feelings of being faint. A 2D echocardiogram is consistent aortic stenosis. Which of the following plans should NOT be included in the intermediate treatment?

• A referral to a cardiologist within 7 days
• A cardiac stress test
• Advise to limit exercise until having a consultation with a cardiologist
• Review of diet including a low sodium diet
• A 69 y/o male presents with symptoms of A. Fib. An ECG and transesophageal

echocardiogram are ordered. A transesophageal echocardiogram will be able to identify which of the following?

• Heart rhythm
• Bundle branch block
• Prior myocardial infarction
• Images of heart without interference of lungs
• A 52 y/o male patient presents with a diagnosis of non-complicated diverticulitis disease.

What non-pharmacological recommendations should be made for the

• Avoid seeds or nuts in diet
• Elevate head while sleeping
• Follow a DASH diet
• Increase dietary fiber
• Which statement best describes the reason for psychological observation and n.. in a patient

with differential diagnosis of IBS?

• A diagnosis of IBS is likely to cause depression
• IBS can alter life span
• While not a direct cause, stress and anxiety can exacerbate the symptoms of IBS
• Most uncomplicated IBS stems from psychological causes as opposed to physical
• Which of the following would NOT be considered a risk factor for C-diff diarrhea?
• Penicillin or other antibiotic use
• Gender
• Antineoplastic agents

• Advanced age
• Which of the following has the highest risk factor for anemia?
• Recent hospitalization
• Antibiotic use
• Age less than 40
• Chronic disease such as kidney or liver
• A pt present with a diagnosis of anemia. Which medications may interfere with absorption,

resulting in a vitamin deficiency?

• Antibiotics
• Analgesics
• Antivirals
• Anticonvulsants
• Which demographic group has a genetic risk for pernicious anemia?
• Women or men from the Thalassemia belt
• Women of northern European descent
• African American men
• Children
• Which pharmacologic intervention would be the most appropriate for a patient with a

diagnosis of pernicious anemia?

• Iron supplements
• Daily multi-vitamin
• Vitamin b12
• Antibiotics
• Which of the following tests would be used to diagnose pernicious anemia?
• Schilling test
• CAGE questionnaire
• Gold stage
• Centor criteria
• Which of the following are most likely to cause GI bleeding?
• Acetylsalicyclic acid
• Antibiotics
• Antivirals
• Hormones
• A patient being treated for ED would be considered high risk for treatment if also suffering

from which of the following conditions?

• Refractory angina