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100 Cards in this Set
- Front
- Back
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Which of the following is NOT true concerning direct reimbursement for nurse practitioners under Medicare Part B?
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The Balanced Budge Act of 1997 gave nurse practitioners direct Medicare reimbursement at 85% of the physician rate.
Medicare law defines "collaboration" as a process in which a nurse practitioner works with a physician to deliver healthcare services within the scope of the practitioner's professional expertise. Nurse practitioners do not have to accept assignment from Medicare to receive reimbursement. Billing in a physician's office setting reimburses the physician practice at 100%. Hide ExplanationExplanation:The Correct answer is:Nurse practitioners do not have to accept assignment from Medicare to receive reimbursementNurse practitioners must accept assignment from Medicare in order to receive reimbursement. The remaining answer choices are correct concerning direct reimbursement for nurse practitioners under Medicare Part B. |
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The Wood's lamp is used to evaluate skin lesions. You are examining a patient and when the light is shown on the patient's skin, you see a green-yellow fluorescence which indicates:
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keratinized cells
lichenification bacterial colonies presence of fungi Hide ExplanationExplanation:The Correct answer is:Presence of fungi These fungal lesions will be visualized as green-yellow fluorescence when viewed with the Wood's lamp in a dimly lit room. |
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When choosing a blood pressure cuff for a young child, what size should it be?
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2/3 upper arm.
All of the upper arm. 1/2 upper arm. You do not use a blood pressure cuff. Hide ExplanationExplanation:Correct Answer:2/3 upper arm. Children do need their blood pressure taken occasionally. The cuff should not be any larger than 2/3 the size of the child's arm. Because this varies with age, and exact size is not given. |
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A bounding pulse would be noted in the medical record as which of the following?
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0
1+ 3+ 4+ Hide ExplanationExplanation:Correct answer:4+ The scale for rating the pulse ranges from 0 (absent) to 4+ (bounding). Pulses are taken not only for the heart but also in peripheral areas such as a femoral pulse or popliteal pulse. |
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When treating a patient with a topical agent, you anticipate the greatest rate of absorption when it is applied to:
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face
ankles palms of the hands soles of the feet Hide ExplanationExplanation:The Correct answer is:faceCertain parts of the body, notably the face, axillae, and genital area, are quite permeable, allowing for greater absorption of medication. Less permeable areas are the extremities and trunk. The palms of the hands and soles of the feet create a barrier so little absorption occurs there. |
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You are assessing a patient who complains of pain around her navel. She has a low-grade fever and chills. She says the pain around her belly button started out dull but has increased. She vomited shortly after arriving at the ED. Which of the following conditions is this patient showing signs and symptoms of?
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Myocardial infarction.
Gallstones. Appendicitis. Peptic ulcer. Hide ExplanationExplanation:Correct Answer:AppendicitisIt can be particularly hard to diagnose appendicitis in women. Early symptoms of the condition include a pain around the belly button that gets more severe over time. The pain may migrate into the right lower quadrant of the abdomen. Low fever, nausea, vomiting, and chills are also early signs of the condition. |
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Which test would you order to determine whether a patient has systolic heart failure or diastolic heart failure? |
CTA scan. Stress test. Echocardiogram. Chest x-ray. Hide ExplanationExplanation:Correct answer:EchocardiogramAn echocardiogram shows images of the heart using waves. This image helps determine whether there is systolic heart failure or diastolic heart failure. A chest x-ray is not as detailed, and a stress test determines the reaction to exertion. |
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A parent asks which vaccines her child should receive at her 2 month visit. A child should receive all but which of the following vaccines at this age? |
Hepatitis B. Rotavirus. Diphtheria, tetanus, and pertussis. Measles, mumps, and rubella. Hide ExplanationExplanation:Correct Answer: Measles, mumps, and rubella The MMR vaccine is not given until a child is at least 12 months old. A child being vaccinated at a 2 month visit should receive Hepatitis B if it was not given at 1 month, as well as rotavirus, DTaP, Hib, PCV, and IPV vaccines. |
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Your patient is describing his stresses. You say, “You mentioned your job. Can you tell me more about it?” This is known as which of the following? |
clarifying acknowledging focusing reflection Hide ExplanationExplanation:Correct answer:focusing Your statement is a technique of therapeutic communication. It is focusing the client on one topic. It assists him in pursuing an idea or feeling and eliminates peripheral communication. |
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A murmur is suspected in an elderly patient. As soon as the stethoscope is placed on the patient's chest, a quiet sound is heard. Which of the following grades is this type of murmur? |
III/VI. IV/VI. V/VI. II/VI. Hide ExplanationExplanation:Correct Answer:II/VI. Each of the preceding murmur grades is defined below: III/VI - Moderately loud IV/VI - Loud with palpable thrill V/VI - Very loud and heard with the stethoscope partially off the chest; palpable thrill II/VI - Quiet but heard as soon as the stethoscope is placed on the chest |
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You have a patient who has recurrent, repetitive, and intrusive thoughts that are extremely difficult for her to control. This patient has which of the following disorders? |
panic disorder obsessive-compulsive disorder social phobia generalized anxiety disorder Hide ExplanationExplanation:Correct answer:obsessive-compulsive disorder Patients with obsessive-compulsive disorder (OCD) have recurrent, repetitive, and intrusive thoughts and/or behaviors that are extremely difficult or impossible to control. They are unreasonable, excessive, and interfere significantly with a person’s ability to function. |
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You are prescribing Medroxyprogesterone acetate as the Hormone Replacement Therapy for your elderly patient. Which of the following is a brand name for this drug? |
Menest. Ogen. Provera. Aygestin. Hide ExplanationExplanation:Correct Answer:Provera. Menest is the brand name for Esterified estrogen and Ogen, Estropipate. Provera is the brand name for Medroxyprogesterone acetate and Aygestin, Norethindrone acetate. |
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Mrs. Worley is a 78-year-old patient who has diverticulitis. Which of the following medications are you least likely to prescribe for Mrs. Worley? |
trimethoprim/sulfamethoxazole Imitrex metronidazole Cipro Hide ExplanationExplanation:Correct answer:Imitrex Imitrex is not a medication for diverticulitis. It is a medication used for migraine headaches. All of the other medications might be used to treat diverticulitis. For severe cases the patient may have to be hospitalized. |
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In examining a pregnant woman, if the FNP finds that the uterus is about grapefruit size, she knows that it is most likely that the woman is in what week of pregnancy? |
8th 16th 12th 20th Hide ExplanationExplanation:Correct answer:12th At 12 weeks the uterus is about softball or grapefruit s |
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The FNP has recommended isometric exercises for a patient who is recovering from a joint injury. All of the following statements about isometric exercises are true EXCEPT: |
They are controlled and sustained contraction and relaxation of a muscle group. They are helpful for those with osteoporosis. They are less stressful on joints than regular exercise. They are usually done first before active exercise post injury. Hide ExplanationExplanation:Correct Answer:They are helpful for those with osteoporosis. Isometric exercises are non-weight-bearing exercises. Only weight-bearing exercises work for osteoporosis (for instance, walking or biking). |
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An adult patient suffered head trauma. There is a positive reaction to the startle reflex. What type of assessment is necessary? |
Dietary. Neurological. Cardiac. Digestive. Hide ExplanationExplanation:Correct answer: Neurological The startle reflex is an infant reflex. In adults, it can be a sign of brain damage. A neurological assessment is necessary. |
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A woman of Asian descent comes in and you observe a slight stoop in her shoulders. She is 60 and complains of neck pain. What will you want to check in her medical history? |
Complex carbohydrate intake. Immunizations. Osteoporosis. Anemia. Hide ExplanationExplanation:Correct answer: Osteoporosis The patient is at risk of osteoporosis because of her age and heritage. The "matron hump" is also indicative of osteoporosis. Osteoporosis could explain the neck pain. |
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You are conducting an assessment with a patient who says she knows that she needs to change several habits, such as smoking, in order to be more healthy. However, she says that she just lacks the will power. Besides, she says, it won't matter -- her life is so stressful that she will continue to be sick, and there is no way that she can make changes to lower her stress. She expresses that she knows she is stuck and has to deal with her life as it is. This patient is expressing which of the following? |
Hopelessness. Helplessness. Powerlessness. Ineffective family coping. Hide ExplanationExplanation:Correct Answer: Powerlessness Powerlessness can sometimes accompany a serious diagnosis, though patients with a variety of health conditions may feel powerless. It is important to diagnose this so that interventions can be taken to help empower the patient, including referral to appropriate mental health services if necessary. |
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NSAID and corticosteroid use are potent risk factors in which of the following types of peptic ulcer disease? |
gastric ulcer duodenal ulcer nonerosive gastritis chronic type B gastritis Hide ExplanationExplanation:Correct answer:gastric ulcer NSAID and corticosteroid use is a potent risk factor for gastric ulcers. Cigarette smoking is also a risk factor. Nearly all gastric ulcers found in patients without H. Pylori infection are caused by NSAID use. |
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While examining your 50-year-old female patient you hear a high-pitched diastolic murmur at the second ICS at the right side of the sternum. You know that this indicates which of the following? |
mitral regurgitation aortic stenosis mitral stenosis aortic regurgitation Hide ExplanationExplanation:Correct Answer:aortic regurgitationA high-pitched diastolic murmur which is best heard at the second ICS at the right side of the sternum indicates aortic regurgitation. Aortic stenosis produces a harsh and noisy murmur and radiates to the neck. |
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The FNP has a 22-year-old female patient with a history of heavy bleeding during her periods. She is complaining of fatigue and a sore red tongue. The FNP suspects iron deficiency anemia and orders lab tests. Which of the following lab results would the FNP expect to see for this patient? |
increased hemoglobin MCV >80 fL MCHC: pale color TIBC < 240 mcg/dL Hide ExplanationExplanation:Correct answer:MCHC: pale color For this patient the FNP would expect to see the following: decreased hemoglobin and hematocrit; MCV < 80 fL; MCHC: pale color; and increased TIBC. |
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You are conducting an assessment with a 24 year old male patient who reports burning during urination and discharge from the penis. He is sexually active and reports not using condoms regularly. Which of the following is the most likely diagnosis for this patient? |
Gonorrhea. Syphilis. Urinary tract infection. Candidasis. Hide ExplanationExplanation:Correct Answer: Gonorrhea Men with gonorrhea typically have painful burning during urination and also a penile discharge. Women are likely to be asymptomatic. |
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Which of the following tests would you order for your client as an adjunct to evaluate a genital herpetic infection? |
KOH slide Tzanck smear Pap smear Gram stain Hide ExplanationExplanation:Correct answer:Tzanck smear The Tzanck smear is used as an adjunct for evaluating herpetic infections (oral, genital, or skin). A positive smear will show large abnormal nuclei on the squamous epithelial cells. |
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You are testing the serum creatinine of a 50-year-old female patient. You would expect the results (if normal) to be in which of the following ranges? |
0.7 to 1.3 mg/dL 0.1 to 1.0 mg/dL 0.6 to 1.1 mg/dL 0.4 to 1.5 mg/dL Hide ExplanationExplanation:Correct Answer:0.6 to 1.1 mg/dLSerum creatinine norm is 0.6 to 1.1 mg/dL for females. It is 0.7 to 1.3 mg/dL for males. |
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Which of the following statements about depression therapy is incorrect in regard to the length of pharmacological intervention in depression? |
Therapy should be a minimum of 9 – 12 months. The acute phase of treatment to bring symptoms under control and into remission lasts up to 3 months. Relapse is highest after the second month after discontinuation of treatment. Medication should be continued for a minimum of 6 months after depression remission is achieved. Hide ExplanationExplanation:Correct Answer:Relapse is highest after the second month after discontinuation of treatment. Relapse is highest in the first 2 months after discontinuation of treatment. Maintenance therapy should be considered as with any chronic illness. |
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Which of the following screening and assessment tests used in child health supervision is NOT used exclusively for developmental screening and assessment for infants and/or toddlers? |
Denver II First Step Ages and Stages Questionnaire HOME scale Hide ExplanationExplanation:Correct answer:HOME scale The HOME scale is not used exclusively for infants/toddlers. It is the Home Observation for Measurement of the Environment scale. It has infant, preschool and elementary school versions |
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If a patient suffers from obsessive-compulsive disorder, but also suffers from major depression, these disorders are said to be: |
codependent comorbid mutually supporting inter-reliant Hide ExplanationExplanation:Correct Answer:comorbidMany individuals have more than one mental disorder at a time; this is known as having a comorbid condition. If a condition is comorbid it coexists with an unrelated condition. |
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You are assessing a teenage patient who has arrived with a severe sore throat, swollen glands, and a temperature of 101.6F. She says she feels incredibly weak. Which of the following tests would you order for this patient? |
Sputum culture. CBC. Monospot. EKG. Hide ExplanationExplanation:Correct Answer:MonospotThis patient's signs and symptoms are consistent with mononucleosis. A blood test will be necessary to confirm that diagnosis. You may wish to rule out strep throat or other bacterial infections as well. |
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Differentiation of transient ischemic attack and cerebrovascular accident classifies the conditions as either ischemic or hemorrhagic. Hemorrhagic syndromes include subarachnoid hemorrhaging. Symptoms of subarachnoid hemorrhage include: |
Slow onset of headaches. Vomiting. Increase consciousness. Ataxia. Hide ExplanationExplanation:Correct answer:VomitingSubarachnoid hemorrhaging occurs in cerebrovascular accidents. Symptoms include sudden onset of headaches, vomiting, decreased consciousness with or without focal neurological signs. |
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A urine specimen used for monitoring insulin therapy in persons with diabetes mellitus is which of the following? |
three-glass collection first morning specimen 2-hour postprandial specimen random specimen Hide ExplanationExplanation:Correct answer:2-hour postprandial specimen In the 2-hour postprandial specimen, the patient voids shortly before consuming a routine meal and then collects a specimen 2 hours after eating. The specimen is tested for glucose, and the results are primarily for monitoring insulin therapy in persons with diabetes mellitus. |
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A patient has a seizure. There is a medical history of hypoglycemia. What is the blood sugar likely to test? |
35 mg/dL. 70 mg/dL. 80 mg/dL. 50 mg/dL. Hide ExplanationExplanation:Correct answer: 35 mg/dL A severe drop in blood sugar can cause seizures or coma. A glucose test below 40 mg/dL or below indicates severe hypoglycemia. If the test is higher, there may be another cause for the seizure. |
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Persons who are allergic to latex products are often allergic to all of the followingEXCEPT: |
oranges kiwi bananas avocado Hide ExplanationExplanation:Correct Answer:orangesIt has been noted that those persons with latex allergy also often have a cross-allergy to kiwi, bananas and avocado. Oranges pose no cross-allergy threat, making this the right answer in this case. |
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Which of the following would be a valid outcome criterion for an overweight patient with impaired mobility? |
Before discharge, the patient will feel a decrease in pain while ambulating. Before discharge, the patient will promise to do the recommended exercises every day. Before discharge, the patient will ambulate the length of the hallway independently. any of the above Hide ExplanationExplanation:Correct Answer:Before discharge, the patient will ambulate the length of the hallway independently.Outcome criteria should be realistic, understandable, measurable, observable, and related to the nursing diagnosis. The only outcome criterion that involves all of these is this one. |
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Bowel sounds in a healthy adult patient should sound like all but the following?
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Gurgling.
Bubbling. High pitch. Loud splashing. Hide ExplanationExplanation:Correct Answer: Loud splashing Normal bowel sounds are high-pitched, bubbling, gurgling sounds. They may vary in intensity and volume. Loud splashing may indicate an obstruction or other condition. |
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A geriatric patient with cardiovascular disease is in the office being counseled on lifestyle changes. The nurse practitioner knows that which of the following is the most important to include in this discussion?
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"Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly."
"Have a yearly physical examination, increase fiber in your diet, and exercise regularly." "Maintain a normal level of serum blood sugar and decrease cholesterol intake." "Decrease smoking, increase vitamin supplements, and increase protein intake." Hide ExplanationExplanation:Correct answer: "Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly"Controlling hypertension, cessation of smoking, maintaining a normal weight, and exercising regularly are important for the geriatric patient to decrease cardiovascular risk. The patient might be advised to work on one of these lifestyle changes at a time. Controlling hyperglycemia, high fiber intake, and vitamins all assist in maintaining a healthy lifestyle but do not help to prevent cardiovascular disease. |
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Your patient is a 56-year-old female who has been diagnosed with fibromyalgia. Which of the following medications might be prescribed as a topical treatment for fibromyalgia?
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trazodone
nortriptyline capsaicin pregabalin Hide ExplanationExplanation:Correct Answer:capsaicinTopical treatments such as capsaicin are often helpful treatment adjuncts for a person with fibromyalgia. Medications such as trazodone can be helpful in improving sleep latency and duration. Tricyclic antidepressants such as nortriptyline have been shown to minimize symptoms. Pregabalin (Lyrica) are approved by the FDA for pain reduction in fibromyalgia. |
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Which of the following would you use as a first line treatment for a patient who is having a severe asthmatic exacerbation?
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an adrenaline injection
a rescue inhaler a leukotriene inhibitor a mast cell stabilizer Hide ExplanationExplanation:Correct answer:an adrenaline injection The first line treatment for severe asthmatic exacerbation or respiratory distress is an adrenaline injection. A rescue medication is used to relieve wheezing as needed. A leukotriene inhibitor such as Singulair is a maintenance medication as is a mast cell stabilizer such as Intal. |
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A 27-year-old African-American female is in the office and has been diagnosed with endometriosis. She asks for pain medicine because what she has tried over-the-counter does not help. Which of the following is NOT true regarding pharmacologic treatment for this condition?
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Hormonal contraception may be used.
Provera tablets PO Treatment goals are aimed at pain relief only. NSAIDs are the preferred medications for this. Hide ExplanationExplanation:Correct Answer:Treatment goals are aimed at pain relief only.The goal of endometriosis treatment is for more than pain relief. The goal also includes controlling the endometrial patch growth and preserving fertility. The remaining answer choices are all true regarding treatment of endometriosis. |
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The Global Initiative for Chronic Obstructive Lung Disease (COPD) guidelines specify which medications are indicated for certain stages of COPD. Which is indicated for all stages of the disease? |
an inhaled corticosteroid a short-acting inhaled bronchodilator theophylline guaifenesin Hide ExplanationExplanation:The Correct answer is:A short-acting inhaled bronchodilatorAlbuterol and pirbuterol are beta 2 agonists that are bronchodilator. They are indicated as rescue drugs for treatment of acute bronchospasm for any of the stages of chronic obstructive lung disease. |
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Patients with psychiatric disorders may exhibit escalating behaviors at times. All of the following are appropriate guidelines for interacting with an escalating patient EXCEPT: |
Always stay at a higher eye level than the patient (e.g. stand when patient is sitting). Acknowledge the patient’s complaints or frustration. Use a low, calm tone of voice. Offer choices, options, or small concessions. Hide ExplanationExplanation:Correct answer:Always stay at a higher eye level than the patient (e.g. stand when patient is sitting). This is not suggested. You should always stay at the same eye level as the patient. You should also stand at an angle facing the patient so that it is easier to sidestep if necessary. |
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You are seeing a 7-year-old patient with diarrhea, sore throat, coryza and hoarseness. What is the most likely etiology? |
viral etiology H. parainfluenzae group A Streptococcus mycoplasma Hide ExplanationExplanation:The Correct answer is:Viral etiologyThis group of symptoms is typical of a viral infection. Group A Streptococcus is usually not accompanied by coryza and H. Further, parainfluenzae is not a common cause of pharyngitis. Mycoplasma is not associated with upper respiratory tract infections, but seen in lower respiratory infections. |
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When determining which medication to prescribe for your elderly patient's condition, you decide against a particular anxiolytic/hypnotic because its use increases fall risk. Of the following, which is a benzodiazepine that is known for this? |
Oxazepam. Amitriptyline. Risperidone. Meperidine. Hide ExplanationExplanation:Correct Answer:Oxazepam. All of the medications listed are known to increase fall risk in older adults, however, they are from various medication classes. Oxazepam - Benzodiazepine; Amitriptyline - Antidepressant; Risperidone - SGA; Meperidine - Opioid analgesic/antagonist. |
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Henry is a 40-year-old male patient with blepharitis. You follow-up with Henry in a month and find that there has been no improvement. Of the following choices which would be the optimum next step? |
refer for biopsy check for conjunctivitis inquire about use of eye drops scrub eyelid with a cotton ball Hide ExplanationExplanation:Correct answer:refer for biopsy You might refer this patient for a biopsy. It may be an unusual presentation of basal or squamous cell carcinoma. |
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Which of the following statements about the complications associated with pelvic inflammatory disease (PID) is correct?
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Chronic pelvic pain of unknown cause may be a complication.
Infertility occurs in 1 to 3% of clients after the first episode of PID. A woman with PID is less likely to have an ectopic pregnancy. Fitz-Hugh-Curtis syndrome occurs in 1-5% of cases of pelvic infection. Hide ExplanationExplanation:Correct answer:Chronic pelvic pain of unknown cause may be a complication. This statement is correct. The other statements are not. Infertility occurs in 10 to 30% of clients after the first episode of PID. A woman with PID is more likely to have an ectopic pregnancy as a result of scarred fallopian tubes. Fitz-Hugh-Curtis syndrome occurs in 5 - 30% of cases of pelvic infection. |
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Which of the following patients should be charted as having impaired skin integrity?
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A patient with several small moles on her face.
A patient with a tattoo that is over a year old on her abdomen. A patient with a cut on her finger that is nearly healed. A patient with a scar from bypass surgery. Hide ExplanationExplanation:Correct Answer:A patient with a cut on her finger that is nearly healed.Though the cut is almost healed, it should still be charted as impaired skin integrity. The scar and tattoo would be considered impaired integrity if they were new, but their age and state of healing precludes this. Tattoos, scars, and moles should be charted, though not necessarily as impaired skin integrity. |
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The NP and patient decided the patient's actinic keratosis should be treated with curettage and electrodesiccation. Of the following, which does this define?
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Scraping away the lesion and killing the remaining cells via electricity.
Removing the tumor via cutting and replacing the skin with stitches. Freezing. Burning. Hide ExplanationExplanation:Correct answer: Scraping away the lesion and killing the remaining cells via electricity There are several methods of treating actinic keratosis. The most common methods include: Electrical cautery- Burning Curettage and electrodesiccation - Scraping away the lesion and killing the remaining cells via electricity Excision - Removing the tumor via cutting and replacing the skin with stitchesCryotherapy - Freezing |
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The FNP has a patient who desires to quit smoking. She asks the FNP if there is anything that can help her in trying to quit. The FNP understands that all of the following are true in regard to smoking cessation EXCEPT:
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Bupropion, an atypical antidepressant, is used for smoking cessation.
Bupropion can be used with nicotine products such as gum or nasal sprays. Bupropion is safe to use for persons with a history of seizures. Nicotine patches should not be used with other nicotine products. Hide ExplanationExplanation:Correct answer:Bupropion is safe to use for persons with a history of seizures. This is incorrect. Bupropion (Zyban) is contraindicated in persons with a history of seizures. |
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In educating a client who has recurrent episodes of gout, you would tell him all of the following EXCEPT:
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avoid alcohol binges
avoid fasting avoid low-calorie diets limit fluid intake Hide ExplanationExplanation:Correct answer:limit fluid intake You would encourage generous fluid intake for a person with gout. This helps to avoid kidney stones. |
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Which of the following diseases/conditions is characterized by a Candidal infection of the glans penis and is more common in uncircumcised men? |
Peyronie’s disease Phimosis Varicocele Balanitis Hide ExplanationExplanation:Correct answer:Balanitis Balanitis is characterized by a Candidal infection of the glans penis and is more common in uncircumcised men. Peyronie’s disease is crooked penile erection that is sometimes painful. In phimosis, the foreskin cannot be pushed back from the glans penis due to edema. This is usually seen in neonates. A varicocele is a varicose vein in the scrotal sac. |
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You are conducting an assessment with a female patient who has come in complaining of fatigue and frequent leg cramps. She says that she has gained several pounds lately, though this may be because it is so difficult to exercise when she is tired and weak much of the time. Her skin is rough and pale. The patient should be further evaluated for which of the following? |
Hyperthyroidism. Grave's disease. Type 1 diabetes. Hypothyroidism. Hide ExplanationExplanation:Correct Answer: Hypothyroidism Hypothyroidism occurs when the thyroid does not produce enough thyroid hormone. Patient may be extremely sensitive to cold and experience muscle cramps, fatigue, and weakness. Hair may be coarse and dry and skin may be dry, rough, and pale. |
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When assessing a 6-year-old girl with fever, abdominal tenderness, and an abnormal urinalysis, the mother tells you the child had a recent "strep" infection about 3 weeks ago and did not finish her antibiotics. The nurse practitioner should suspect: |
an antibiotic reaction sepsis gastroenteritis acute glomerulonephritis Hide ExplanationExplanation:The Correct answer is:Acute glomerulonephritisThe symptoms of glomerulonephritis are fever, abdominal or flank pain, edema of the face, hands and feet, abrupt onset of hematuria, oliguria, or anuria. It is most commonly seen in children with a history of recent Group A beta hemolytic streptococcal infection, such as pharyngitis or impetigo. The symptoms do not indicate an antibiotic reaction or sepsis. Further, gastroenteritis usually causes nausea and/or vomiting. |
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The FNP has a 45-year-old female patient who presents with a sudden onset of facial asymmetry and she is unable to make any facial expression on the affected side. If nothing else is found upon examination of this woman, which of the following cranial nerves is likely paralyzed? |
CN II CN III CN VI CN VII Hide ExplanationExplanation:Correct Answer:CN VII Cranial nerve VII is related to facial function. Dysfunction of this nerve gives the characteristic findings of Bell’s palsy (facial asymmetry, droop of mouth, absent nasolabial fold, and impaired eyelid movement). |
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Your elderly patient has developed a disorder as a result of asthma. Of the following, which did he MOST likely develop? |
Airway disorder. Pulmonary edema. Parenchymal lung. Pulmonary vascular. Hide ExplanationExplanation:Correct answer:Airway disorderThere are a variety of disorders in which acute respiratory failure may occur. Others include chest, wall, and diaphragm, neuromuscular, and central nervous system disorders. |
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You have ordered a lipid panel for your patient who you suspect has a chronic renal insufficiency. Which of the following lipid abnormalities would be associated with chronic renal insufficiency? |
low HDL elevated total cholesterol, triglycerides and LDL elevated total cholesterol and triglycerides elevated triglycerides, HDL and LDL Hide ExplanationExplanation:Correct answer:elevated total cholesterol and triglycerides Lab results in a person with chronic renal insufficiency can show elevated total cholesterol and triglycerides. Low HDL can be associated with chronic inactivity; elevated triglycerides, HDL and LDL with alcohol abuse; and elevated total cholesterol, triglycerides and LDL with undertreated or untreated hypothyroidism. |
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You are talking to the parents of a child who whom you have diagnosed with rheumatic fever. Of the following statements which one are you NOT likely to include in educating them about rheumatic fever? |
Rheumatic fever is a collagen disease. Rheumatic fever is the most common cause of acquired heart disease in children. Rheumatic fever usually affects the aortic and mitral valves of the heart. Rheumatic fever is a common complication of congenital heart disease. Hide ExplanationExplanation:Correct answer:Rheumatic fever is a common complication of congenital heart disease. Rheumatic fever is not a common complication of congenital heart disease. Congestive heart failure is. Rheumatic fever is an inflammatory disease that is the most common cause of acquired heart disease in children. It usually affects the aortic and mitral valves of the heart. It is associated with a streptococcal infection and is a collagen disease that injures the heart, blood vessels, joints, and subcutaneous tissue. |
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Sally is an 18-year-old female who you suspect has an eating disorder. Which of the following findings is most likely to support this potential diagnosis? |
orthostatic hypotension increased temperature tachycardia normal heart rhythm Hide ExplanationExplanation:Correct answer:orthostatic hypotension This is a finding that would support a diagnosis of an eating disorder. There may be other signs as well such as yellowing of skin, brittle nails, pruritus, halitosis, decreased temperature, bradycardia, and arrhythmia. |
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Your patient who is bedridden has developed pressure ulcers. Your examination reveals that there has been damage to the epidermis with blisters forming. The wound bed is pink in color. This would be a pressure ulcer in which of the following stages? |
unstageable stage IV stage III stage II Hide ExplanationExplanation:Correct answer:stage II Pressure ulcer staging ranges from I to IV plus unstageable or unclassified. This patient has a stage II pressure ulcer which is characterized by damage to the epidermis where blisters form and erupt into red shiny skin or shallow superficial ulcers. The wound be is pink to red in color. |
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Polycystic ovary syndrome (PCOS) is a hormonal abnormality marked by anovulation, infertility, excessive androgen production, and insulin resistance. Which of the following medications would you prescribe to decrease and control hirsutism associated with PCOS? |
low-dose oral contraceptives Provera tablets Spironolactone Glucophage Hide ExplanationExplanation:Correct Answer:SpironolactoneSpironolactone would be used to decrease and control hirsutism. Low-dose oral contraceptives will suppress ovaries. Provera tablets induce menses. Glucophage is used to induce ovulation if pregnancy is desired. |
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Fracture patterns are described as all of the following EXCEPT: |
transverse oblique Salter-Harris greenstick Hide ExplanationExplanation:Correct answer:Salter-Harris Salter-Harris is the classification system used to describe growth plate fractures in children. It is not a type of fracture. Fracture patterns are described as transverse, oblique, spiral, comminuted, or greenstick. |
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You are examining a 68-year-old female who complains of having pain in the lower left quadrant of the abdomen after eating. Which of the following might indicate a diagnosis of diverticulitis? |
high fasting glucose low blood pressure alternating diarrhea and constipation tarry stools Hide ExplanationExplanation:Correct Answer:alternating diarrhea and constipationThis is something you might find in a patient with diverticulitis. Other findings may include: depressed bowel sound (or increased if there is an obstruction); tender, firm palpable mass present in the left iliac fossa; and tender rectum upon examination. |
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Which of the following laboratory procedures would be most useful for clinical diagnosis of gonorrhea? |
Pap smear KOH slide Gram stain Tzanck smear Hide ExplanationExplanation:Correct answer:Gram stain A Gram stain is useful for diagnosing gonorrhea in the clinical area. Under high power, the white blood cells are examined for Gram-negative bacteria after the specimen has been stained. |
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In regards to hypothyroidism, the nurse practitioner knows that periodic monitoring for this condition is indicated in the presence of which of the following conditions? |
Down syndrome male gender alcoholism antihypertensive use Hide ExplanationExplanation:The Correct answer is:Down syndromeThyroid disease exists in less than 7% of the population but is seen commonly in patients with Down syndrome. Other risk factors associated with this condition include advancing age, use of certain medications that alter thyroid hormone synthesis, female gender, postpartum, strong family history of autoimmune diseases, and history of radiation or surgery to the head and neck. |
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Of the following, which type of lesion is associated with psoriasis? |
macule vesicle plaque wheal Hide ExplanationExplanation:Correct answer:plaque Psoriasis has plaque-type skin lesions. They are raised lesions, > 1 cm, and may be the same or different color from the surrounding skin. |
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For your patient with diverticulitis you would recommend eating which of the following foods? |
peaches strawberries popcorn raspberries Hide ExplanationExplanation:Correct Answer:peachesThis is the only food of the choices that you might recommend. Corn, popcorn, and nuts, along with fruits and vegetables with seeds, are foods that you would not recommend for a person with diverticulitis. |
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A patient appears apathetic and reports recent loss of income and loved ones. Which of the following assessment might you do after a preliminary diagnosis? |
ANA. NANDA. NGASR. ABC. Hide ExplanationExplanation:Correct Answer:NGASR.The Nurses Global Assessment Risk for Suicide (NGASR) assesses a patient's suicide risk. Apathy and personal loss can be indicators of suicide risk. Further assessment is needed. |
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Which of the following herbal over-the-counter medicines is used for anxiety and/or depression? |
Kava kava St. John’s Wort Valerian root All of the above Hide ExplanationExplanation:Correct answer:All of the above All of the choices are herbal remedies for anxiety and/or depression. St. John’s Wort acts like MAOI, SSRI, or TCA. Kava kava has action at GABA receptors similar to benzodiazepines. Valerian root also has action similar to benzodiazepines. |
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Which of the following heart sounds is caused by the increased resistance from a stiff left ventricle? |
S1 systole S2 diastole S3 heart sound S4 heart sound Hide ExplanationExplanation:Correct answer:S4 heart sound The S4 heart sound is caused by the increased resistance from a stiff left ventricle. It usually indicates left ventricular hypertrophy. It may be considered as a normal finding in some elderly patients with no heart disease. |
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You are prescribing a neuropathic analgesic for a patient who has peripheral vascular disease. Which of the following drugs is a neuropathic analgesic? |
Pentoxifylline Dipyridamole Clindamycin Amitriptyline Hide ExplanationExplanation:Correct Answer:AmitriptylineAmitriptyline is an antidepressant that is used for neuropathic pain treatment. Many adjuvant analgesics such as amitriptyline have proven more effective at treating chronic nerve pain symptoms than traditional painkillers. |
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Which of the following would be the least appropriate guideline for teaching plans for critical care patients and families? |
Establish the outcome of the teaching. Determine what content needs to be taught. Give the patient and family as much information as possible from every source possible. Determine the most appropriate teaching strategy. Hide ExplanationExplanation:Correct Answer:Give the patient and family as much information as possible from every source possible.This is the least appropriate guideline. The teaching strategy for critically ill patients and families must be planned carefully. Patients and families in the critical care setting are stressed and an overload of information adds to their stress. When planning education, consider content and amount based on the assessment of the patient and family. |
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Marge is a 44-year-old patient with Type I Diabetes Mellitus. She takes an ultra-short acting insulin to help manage her condition. Of the following, which insulin does she MOST likely take? |
NPH. Lantus. Humalog (lispro). Novolin. Hide ExplanationExplanation:Correct answer: Humalog (lispro) There are a variety of Insulin types that are used to help manage Type I Diabetes. These range from ultra-short-acting to long-acting peakless. Humalog (lispro) is ultra-short-acting, while Novolin is short-acting. NPH is intermediate-acting and Lantus, long-acting peakless. |
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Which of the following is NOT an absolute contraindication to postmenopausal estrogen therapy? |
seizure disorder unexplained vaginal bleeding acute liver disease neruo-ophthalmologic vascular disease Hide ExplanationExplanation:Correct Answer:seizure disorderAll of the choices are absolute contraindications to postmenopausal estrogen therapy except seizure disorders. In the case of seizure disorders, estrogen therapy can be used with caution, considering if the benefit outweighs the risk. |
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Which of the following characteristics is not typical of melanoma? |
uneven texture pink-to-red targetlike lesions mixed colors irregular borders Hide ExplanationExplanation:Correct Answer:pink-to-red targetlike lesionsThis is not typical of melanoma. Melanoma is characterized by dark-colored moles with uneven texture, mixed colors and irregular borders. The moles may be pruritic. |
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In advising a pregnant woman, which of the following would be incorrect? |
Always wear a seat belt (below the uterine fundus). Avoid exercise in hot and humid weather. Relax in a hot tub or sauna when stressed. Eat no raw shellfish or raw meat. Hide ExplanationExplanation:Correct Answer:Relax in a hot tub or sauna when stressed.The FNP would not advise a pregnant woman to use a hot tub or sauna. Raising the core body temperature during pregnancy can harm the fetus, particularly in the early stages of development. The patient would be advised not to use them. |
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A patient who has been prescribed azithromycin in suspension form should be instructed to do all but which of the following? |
Shake the medication well before taking it. Mix up several doses ahead of time and store in the refrigerator. To swallow a dose, then add water to the glass, swirl gently, and drink to make sure that all the dose is taken. Mix the medication with 2 ounces of water. Hide ExplanationExplanation:Correct Answer:Mix up several doses ahead of time and store in the refrigeratorAzithromycin should be mixed immediately prior to dosage. It should not be mixed up and saved for later. Azithromycin must be well shaken and mixed in 2 oz of water. The patient should drink the dose, then swirl a small amount of water in the glass and drink to ensure that all the dose is taken. |
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A patient comes to the clinic with diffused red skin in the area where he tells you he cut his arm on a piece of machinery at work. He tells you that it has worsened in the last couple of days. Upon examination, you find that the area is indurated, swollen, and tender. Which of the following are you most likely to diagnose for this patient? |
psoriasis tinea versicolor acute cellulitis actinic keratosis Hide ExplanationExplanation:Correct answer:acute cellulitis Of the choices given, acute cellulitis is the most likely diagnosis. It is a skin infection caused by Gram-positive bacteria and points of entry are skin breaks such as insect bites, abrasions or cuts. |
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______ is an example of a dopamine agonist that can be used in the treatment of neurological disorders. |
Hydantoin. iperazine. Flurazepam. Bromocriptine. Hide ExplanationExplanation:Correct answer: Bromocriptine All of the medications listed can be used in the treatment of neurological disorders, however, they are different classes of drugs. Hydantoin - Anticonvulsant Piperazine - Antipsychotic Flurazepam - Benzodiazepine Bromocriptine - Dopamine Agonist |
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Which of the following may indicate that a patient has low self-esteem, which may in turn be negatively impacting his mental and physical health? |
Lack of religious beliefs. Few close friendships. Strong religious beliefs. Poor personal hygiene. Hide ExplanationExplanation:Correct Answer: Poor personal hygiene All the answers listed are items that might be relevant to the patient's overall health and should be explored during the psychosocial assessment. However, poor personal hygiene is often a sign of low self-esteem or depression and should be noted and explored. It may also indicate other types of impaired functioning. |
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Diagnosis for bronchiolitis is based on several factors. Which of the following is one of these factors? |
CBC abrupt onset of wheezing chest radiograph RSV culture Hide ExplanationExplanation:Correct answer:abrupt onset of wheezing Diagnosis for bronchiolitis is based on this as one of the findings. The patient may also have difficulty breathing; and physical examination would support hyperinflation. CBC is not usually needed. Chest radiograph is not usually needed. RSV culture is not usually done. |
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When a pregnant woman’s uterine fundus first rises above the symphysis pubis, the woman is about how many weeks pregnant? |
12 weeks 16 weeks 20 weeks 24 weeks Hide ExplanationExplanation:Correct answer:12 weeks At 12 weeks the uterine fundus first rises above the symphysis pubis. Fetal heart tones are heard by Doppler by 10 – 12 weeks. |
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The most cost-effective method of diagnosing H. pylori infection is which of the following? |
stool antigen testing UGI endoscopy serological testing biopsy Hide ExplanationExplanation:Correct answer:stool antigen testing Stool antigen testing is the most cost-effective way to diagnose H. pylori infection. It is particularly effective when it is coupled with a clinical presentation consistent with peptic ulcer disease. |
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Which of the following diagnostic studies would you order for a patient who you suspect may have West Nile Virus? |
rapid antigen test nasopharyngeal cultures CSF with IgM antibody for WNV ASO titer Hide ExplanationExplanation:Correct answer:CSF with IgM antibody for WNV West Nile virus first appeared in the United States in 1999. It is a viral infection causing febrile illness, rash, arthritis, myalgias, weakness, lymphadenopathy, and meningoencephalitis. CSF with IgM antibody for WNV is confirmative. |
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Which of the following factors would increase the susceptibility of a person for glaucoma? |
corticosteroid therapy mental illness history of pneumonia history of heart disease Hide ExplanationExplanation:Correct Answer:corticosteroid therapyThere are many factors that increase a patient’s susceptibility to glaucoma. Corticosteroid therapy is one of them. Others include: eye inflammation or trauma; neoplasm; neovascularization; and increasing age. |
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Herbal and nutritional therapies are considered emerging therapies for prostatic disease. Which of the following is NOT one of these emerging therapies? The use of: |
rye kava kava pumpkin palmetto Hide ExplanationExplanation:Correct answer:kava kava Kava kava is not one of the herbal therapies for diseases of the prostate. Palmetto, rye and pumpkin are considered emerging therapies by the American Urological Association, pending further studies. |
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When your patient with pertussis seems to have a lingering cold and the cough worsens, he is in which of the following stages of the disease? |
latent catarrhal paroxysmal convalescent Hide ExplanationExplanation:Correct answer:paroxysmal At the onset of the paroxysmal stage of the disease, the person with pertussis seems to have a lingering cold. Although the nasal symptoms are usually resolved, the cough worsens because the pathogen has attached to the respiratory cilia and produced toxins that paralyze the cilia and induce inflammation of the respiratory tract. |
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Your elderly patient has a moderate hearing loss. You understand that this means that the loss is in which of the following ranges? |
26 – 40 dB 41 – 55 dB 56 – 70 dB 71 – 90 dB Hide ExplanationExplanation:Correct answer:41 – 55 dB The hearing loss is in the 41 – 55 dB range. A mild hearing loss is 26 – 40 dB. A profound hearing loss is more than 91 dB. |
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A 16 year old cheerleader comes in with a chronic case of laryngitis. The condition is worsening even though she has been resting her voice and there is no sign of infection. What step do you take? |
Refer to a specialist. X-ray. CBC. Prescribe antibiotics. Hide ExplanationExplanation:Correct answer: Refer to a specialist Laryngitis should clear up on its own unless it is an infection. If there is no infection and the condition becomes worse, the best choice is to refer the patient to a specialist rather than come to a faulty diagnosis. |
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You are conducting an assessment with a patient who reports heavy menstrual bleeding and pelvic pain. A pelvic exam reveals that her uterus is larger than normal. She is not pregnant. Which of the following procedures would you order to confirm a diagnosis of uterine fibroids? |
Uterine biopsy. External sonogram. Hysterosonogram. Pelvic X-ray. Hide ExplanationExplanation:Correct Answer: Hysterosonogram This procedure, in which the uterus is filled with saline and a transvaginal pelvic ultrasound is performed, is often used to diagnose uterine fibroids. If the patient reports other complaints, such as bowel or urinary problems, she may require other tests to rule out other causes. |
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Your adult female patient tells you that she has lost a large amount of weight in a short amount of time, has become irritable and anxious, and is frequently bothered by insomnia. Your examination of this patient reveals a diffusely enlarged thyroid gland without nodules, and tachycardia. Of the following which is the most likely diagnosis for these symptoms? |
Grave’s disease thyroid cancer hyperprolactinemia pheochromocytoma Hide ExplanationExplanation:Correct answer:Grave’s disease Grave’s disease is an autoimmune disorder of the thyroid gland causing hyperfunction and production of excess thyroid hormones. There is a higher incidence in females (8:1 ratio). In later stages of Grave’s disease there can also be exophthalmos (protruding eyeballs). |
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When treating skin disorders, the nurse practitioner knows that which of the following is the LEAST potent topical corticosteroid? |
hydrocortisone 2.5% fluocinonide 0.05% betamethasone dipropionate 0.1% desoximetasone 0.25% Hide ExplanationExplanation:The Correct answer is:Hydrocortisone 2.5%The medications listed as answer choices desoximetasone 0.25%, betamethasone dipropionate 0.1% and fluocinonide 0.05% are all medium or high potency corticosteroids. Hydrocortisone 2.5% is a low potency agent. |
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You have diagnosed a patient with TMJ. You might consider referring this patient to a dentist in all but which of the following situations? |
locking or catching of the jaw when opening significant popping during jaw function history of trauma to the face that coincides with the beginning of pain pain that has been present for longer than a week Hide ExplanationExplanation:Correct answer:pain that has been present for longer than a week This is not a reason for referral to a dentist. In addition to the other three choices, also consider referral if there is a change in the way the teeth fit together, significant tooth problems, pain that has been present for longer than 2 months, and the presence of appliances such as splints, bite guards, and occlusal appliances. |
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You are considering estrogen therapy for your 58-year-old postmenopausal patient. Which of the following is NOT an absolute contraindication to postmenopausal estrogen therapy? |
seizure disorder unexplained vaginal bleeding acute liver disease neuro-ophthalmologic vascular disease Hide ExplanationExplanation:Correct Answer:seizure disorder All of the choices are absolute contraindications to postmenopausal estrogen therapy except seizure disorders. In the case of seizure disorders, estrogen therapy can be used with caution, considering if the benefit outweighs the risk. |
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With a 55-year-old African-American male who has sustained an injury at the fifth thoracic vertebra (T5), the nurse practitioner understands that he will most likely not be able to: |
achieve lower body strength and coordination for walking have adequate upper body strength to drive a car maintain the upper body coordination required for eating perform coordinated movements with his hands, such as writing Hide ExplanationExplanation:The Correct answer is:Achieve lower body strength and coordination for walkingT5 injuries do not affect the coordination or capacity of the upper body, arms, and hands, as the lower body is paralyzed. The client should be able to do all the activities listed except walk. |
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A patient has been admitted with a spinal cord injury from an automobile accident. He has complete paralysis and lack of sensation below the lesion. You realize that this spinal shock must be reversed as quickly as possible. Which of the following is the most vital reason why it must be reversed as quickly as possible? |
Urinary tract infection is possible if the spinal cord is compressed for 12 -24 hours. Bowel functions may be impaired if the spinal cord is compressed for 12 -24 hours. Permanent paralysis may occur if the spinal cord is compressed for 12 -24 hours. BP may be elevated if the spinal cord is compressed for 12 -24 hours. Hide ExplanationExplanation:Correct Answer:Permanent paralysis may occur if the spinal cord is compressed for 12 -24 hours. All of the choices are concerns but the most vital reason why spinal shock must be reversed as quickly as possible is that permanent paralysis may occur if the spinal cord is compressed for 12 -24 hours. Spinal paralysis is a medical emergency that occurs immediately after the injury. |
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Which of the following is a TRUE statement about the Healthy People 2010? |
This model applies only to people of the United States of America. This model is developed and formulated by a special committee formed by an alliance of all the state health departments of the United States of America. This model's objectives are not only applicable nationally, but also internationally. This model has an objective to help people internationally achieve only physical health. Hide ExplanationExplanation:Correct Answer:This model applies only to people of the United States of America.The Healthy People model provides science-based, 10-year national objective for improving the health of citizens in the United States. The Healthy People model assesses progress to: (1) promotes collaborations across sectors; (2) help individuals make better and knowledgeable health decisions; and (3) evaluate the effects of health prevention strategies. Healthy People 2010 is not developed by a committee formed by state health departments, but by the U.S. Department of Health and Human Services. Also, this model does not apply to people internationally, only individuals living within the United States. |
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Of the following, which is a Class III antidysrhythmic that can be prescribed for cardiac disorders? |
Disopyramide. Lidocaine. Encainide. Bretylium. Hide ExplanationExplanation:Correct Answer:Bretylium.Disopyramide - Class IALidocaine - Class IBEncainide - Class ICBretylium - Class III |
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Cholelithiasis is a condition in which there is the formation of gallstones with or without the presence of the gallbladder or associated structure. Major risk factors for this condition include all but which of the following? |
female gender obesity hyperlipidemia hypertension Hide ExplanationExplanation:Correct Answer:hypertension Hypertension is not one of the major risk factors for cholelithiasis. Other major risk factors, besides those in the other three choices include: age older than 50 years, rapid weight loss as in bariatric surgery, pregnancy, genetic factors and ingestion of a diet with a high glycemic index. |
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A mother asks if her child can come out of the car seat. You are counseling the mother on the use of seat belts for her child. You anticipate that the adult car seat belts fit correctly when the child is _____ tall and is _____ old. |
40 inches6 to 8 years
50 inches5 to 6 years 59 inches8 to 12 years 60 inches13 to 15 years Hide ExplanationExplanation:Correct Answer:59 inches8 to 12 yearsChildren should be in a booster seat until they are 59 inches tall or 8 to 12 years of age. Children should remain in the back seat of the car until they are age 13. |
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Mrs. Joseph is a 67-year-old patient with acute bronchitis. Which of the following types of drugs are you least likely to prescribe for this patient to treat her acute bronchitis? |
antitussives mucolytics guaifenesin antibiotics Hide ExplanationExplanation:Correct answer:antibiotics Acute bronchitis requires symptomatic treatment only. You might prescribe all of these three drugs. No antibiotics should be prescribed. Acute bronchitis is characterized by paroxysms of dry coughing and wheezing, and can last up to 4 to 6 weeks. |
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When treating your patient with Osgood-Schlatter disease (OS), you would avoid corticosteroids for which of the following reasons |
They can produce cutaneous thickening. They can produce hyperpigmentation. They may weaken the quadriceps tendon. he patient may become addicted. Hide ExplanationExplanation:Correct answer:They may weaken the quadriceps tendon. This is one of the reasons you would not use corticosteroids for treating a patient with OS. They may also produce cutaneous thinning, and depigmentation. |
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You are treating a patient who presents with a painful, blistering thermal burn on his right hand and digits. What is the best way to treat this? |
Wrap the burn loosely with a nonadherent dressing and prescribe anti-inflammatory agents. Apply silver sulfadiazine cream to the burn and apply a thick dressing. Apply topical antibiotic ointment and leave open to air. Refer to a burn care specialist. Hide ExplanationExplanation:Correct Answer:Refer to a burn care specialist.Patients with any burn involving areas of high function such as the hands and feet or ones that have significant cosmetic consequence such as the face should be referred promptly to specialty care. |
