Family Nurse Practitioner Final Review Qns & Ans 2023/2024, Exams of Nursing

Download Family Nurse Practitioner Final Review Qns & Ans 2023/2024 and more Exams Nursing in PDF only on Docsity! FAMILY NURSE PRACTITIONER FINAL REVIEW QNS & ANS 2023/2024 Which of the following antihypertensive medications should the nurse practitioner avoid when treating patients with emphysema? a. calcium channel blockers b. ACE inhibitors c. beta blockers d. diuretics correct anwer- c A 30 year old chef complains of pruritic hives over her chest and arms but denies difficulty swallowing or breathing. SHe reports a family history of allergic rhinitis and asthma. Which of the following interventions is most appropriate? a. perform a complete and thorough history b. prescribe an oral antihistamine such as diphenhydramine 25 mg PO QID c. give an injection of epinephrine 1:1000 IM stat d. call 911 correct anwer- a Which of the following findings is most likely in young prima gravidas with pregnancy induced hypertension? a. abdominal cramping and constipation b. edema of the face and upper extremities c. shortness of breath d. dysuria and frequency correct anwer- b Which of the following symptoms is associated with B12 deficiency anemia? a. spoon-shaped nails and pica b. an abnormal neurological exam c. a vegan diet d. tingling and numbness in both feet correct anwer- d A second triple screen on a 35 year old primigravida reveals abnormally low levels of the alpha fetoprotein and estriol and high levels of human chorionic gonadatropin. Which of the following interventions is the best choice for this patient? a. order and ultrasound b. order CT scan of abdomen c. order a 24 hour urine for protein clearance d. assess for history of illicit drug or alcohol use. correct anwer- a a. an abnormal knee b. instability of the knee c. a large amount of swelling in the knee d. an injury of the meniscus correct anwer- b A multigravida who is at 28 weeks gestation has a fundal height of 30 cm. Which of the following is the best recommendation for this patient? a. advise the mother that her pregnancy is progressing well b. order an ultrasound of the uterus c. refer her to an obstetrician for an amniocentesis d. recommend bedrest with bathroom privileges correct anwer- a A multigravida who is 34 weeks gestation wants to know at what level her uterine fundal height should be. The best answer is to advise the mother that her fundus is: a. midway between the umbilicus and the lower ribs b. at the level of the umbilicus c. from 33 to 35 cm d. from 32 to 34 cm correct anwer- c Which of the following laboratory tests is used in primary care to evaluate renal function? a. electrolyte panel b. creatinine c. alkaline phosphatase d. blood urea nitrogen to creatinine ratio correct anwer- b All of the following are false statements regarding acute gastritis except? a. chronic intake of non-steroidal anti-inflammatory drugs can cause the disorder b. chronic lack of dietary fiber is the main cause of the disorder c. the screening test for the disorder is the barium swallow test d. the gold standard to evaluate the disorder is the colonoscopy correct anwer- c Signs and symptoms of depression include all the following except? a. anhedonia and changes in appetite b. decreased energy and irritability c. apathy and low self-esteem d. apraxia and fatigue correct anwer- d Which of the following is an accurate description of eliciting for Murphy's sign? a. upon deep inspiration by the patient, palpate firmly in the right upper quadrant of the abdomen below the costovertebral angle b. bend patient's hips and knees at 90 degrees, then passively rotate hip externally, then internally c. ask the patient to squat, then place the stethoscope on the apical area d. press into the abdomen deeply, then release suddenly correct anwer- a A 28 year old multipara who is at 32 weeks gestation presents to your office complaining of sudden onset of small amounts of bright red vaginal bleeding. she has had several episodes and appears anxious. On exam, her uterus is soft to palpation. Which of the following is most likely? a. placenta abruptio b. placenta previa c. acute cervicitis d. molar pregnancy correct anwer- b Epidemiologic studies show that Hashimoto's disease occurs most commonly in: a. middle-aged to older women b. smokers c. obese individuals d. older men correct anwer- a A 48 year old woman is told by a physician that she is starting menopause. All of the following are possible findings except? a. hot flashes b. irregular menstrual periods c. severe vaginal atrophic changes d. cyclic mood swings correct anwer- c A 63 year old patient with a 10 year history of poorly controlled hypertension presents with a cluster of physical findings. Which of the following indicate target organ damage commonly seen in hypertensive patients? a. pedal edema, hepatomegaly, and enlarged kidneys b. hepatomegaly, AV nicking, bibasilar crackles c. renal infection, S3, neuromuscular abnormalities d. glaucoma, jugular vein atrophy, heart failure correct anwer- b A 30 year old primigravida is diagnosed with a possible threatened abortion. The result of the urine pregnancy test is positive. Which of the following statements is true regarding a threatened abortion? a. vaginal bleeding and cramping are present, but the cervix remains closed b. vaginal bleeding and cramping are present along with a dilated cervix c. the fetus and placenta are all expelled d. the products of conception and the placenta remain inside the uterus along with a dilated cervix correct anwer- a A 30 year old female who is sexually active complains of a large amount of milk-like vaginal discharge for several weeks. A microscopy slide reveals a large amount of squamous epithelial cells that have blurred marins. There are very few white blood cells seen. The vaginal pH is 6.0. What is most likely? a. trichomonas infection b. bacterial vaginosis c. candidal infection d. a normal finding correct anwer- b The pap smear result on a 20 year old sexually active student who uses condoms inconsistently shows a large amount of inflammation. Which of the following is the best follow-up action? a. call the patient to return to the clinic so she can get tested for a possible cervical infection b. treat the patient with metronidazole vaginal cream over the phone c. call the patient and tell her she needs to repeat the pap smear in 6 months d. advise her to use a Betadine douche at bed time x 3 days correct anwer- a While performing a pap smear on a postmenopausal patient, several areas of flat white skin lesions that are irregularly shaped are found on the patient's labia. the patient reports that the lesions are extremely itchy and have been present for several years without much change. Which condition is best described? a. chronic scabies infection b. lichen sclerosus c. chronic candidal vaginitis All of the following are false statements about the atopic dermatitis except? a. contact with cold objects may exacerbate the condition b. it does not have a linear distribution c. it is associated with bullae d. the lesions have vesicles that are full of serous exudate correct anwer- b A mother brings in her 4 year old daughter who just started attending preschool. She tells the nurse practitioner that her child is complaining of burning and itching in both eyes along with a runny nose. During the physical exam, the child's eyes appear injected bilaterally. The throat is red and her inferior nasal turbinates are swollen. Which of the following is most likely? a. herpes keratitis b. corneal ulcer c. viral conjunctivitis d. bacterial conjunctivitis correct anwer- c A sexually active woman is complaining of amenorrhea and vaginal spotting. On exam her left adnexa is tender and cervical motion tenderness is positive. Which test should the nurse order initially? a. flat plate of abdomen b. CBC with diff c. urine pregnancy test d. pelvic ultrasound correct anwer- c A toddler with congenital heart disease is seen for a 1 week history of facial and lower extremity edema accompanied by shortness of breath. The child's mother reports that the child's appetite has been poor. The chest xray reveals that the child has congestive heart failure. Which of the following heart sounds are found in these patients? a. S1 and S2 b. S1, S2, and S3 c. S1, S2, and S4 d. Still's murmur and S4 correct anwer- b A 53 year old crossing guard complains of twisting his right knee while working that morning. The knee is swollen and tender to palpation. The NP diagnoses a Grade II sprain. The initial treatment plan includes which of the following? a. application of cold packs the first 24 hours followed by application of low heat at bedtime b. elevation of the affected limb and intermittent application of cold packs for the next 48 hours c. rechecking the knee in 24 hours and isometric exercises d. the application of an ACE bandage to the affected knee correct anwer- b Erythromycin 200 mg with sulfisoxazole 600 mg suspension (Pediazole) is contraindicated in which of the following conditions? a. G6PD deficiency anemia b. lead poisoning c. beta thalassemia minor d. B12 deficiency anemia correct anwer- a The mother of an 11 year old boy with sickle cell anemia calls on the phone complaining her son woke up because of a painful penile erection that will not go away. The NPs most appropriate intervention is? a. Insert foley catheter and measure child's intake and output for next 24 hours b. insert foley catheter and obtain a specimen for a urinalysis and urine C&S c. redommend an increase in the child's fluid intake d. recommend immediate referral to the ER correct anwer- d A positive Coombs test in an Rh-negative pregnant woman means? a. the mother has autoantibodies against Rh positive RBCs b. the fetus has autoantibodies against the maternal RBCs c. the mother does not have Rh factor against fetal RBCs d. the fetus does not have RBC autoantibodies correct anwer- a Folic acid supplementation is recommended for women who are planning pregnancy in order to? a. prevent renal agenesis b. prevent anencephaly c. prevent kidney defects d. prevent heart defects correct anwer- b All the following are possible causes for secondary hypertension except? a. acute pyelonephritis b. pheochromocytoma c. renovascular stenosis d. coarctation of the aorta correct anwer- a Fitz-Hugh-Curtis syndrome is associated with the following infection? a. syphilis b. chlamydia trachomatis c. herpes genitalis d. lymphogranuloma venereum correct anwer- b A nursing home resident reports to his physician that his previous roommate was recently started on tuberculosis treatment. A Mantoux test and chest xray are ordered for the patient. What is the minimum size of induration considered positive for this patient? a. 3 mm b. 5 mm c. 10 mm d. 15 mm correct anwer- c In small children with acquired immunodeficiency syndrome (AIDs), which of the following vaccines is contraindicated? a. diphtheria and tetanus b. hepatitis B and mumps c. varicella d. Td and oral polio correct anwer- c A 44 year old female who is undergoing treatment for infertility complains of not having a menstrual period for a few months. The night before, she started spotting and is now having cramp-type pains in her pelvic area. Her blood pressure is 160/80, the pulse rate is 110, and she is afebrile. Her labs reveal a mild anemia with mild leukocytosis. On pelvic exam, the uterine fundus is found above the symphysis pubis. The cervical os is dilated to 3 cm. Which of the following is more likely? a. inevitable abortion b. threatened abortion c. incomplete abortion d. acute pelvic inflammatory disease correct anwer- a correct anwer- a An elderly patient with a productive cough and fever is diagnosed with pneumonia. ALl of the following organisms are capable of causing community acquired pneumonia except? a. haemophilus influenzae b. mycoplasma pneumoniae c. treponema pallidum d. streptococcus pneumoniae correct anwer- c Human chorionic gonadotropin is produced by the? a. placenta b. hypothalamus c. anterior pituitary d. ovaries correct anwer- a The majority of serum alpha fetoprotein is produced by the? a. fetal liver b. mother's liver c. placenta d. fetal neural tube correct anwer- a Stella works in the housekeeping department of a hospital. She presents to the employee health clinic with a complaint of a needlestick to her left thumb. The needle was in one of the garbage bags from the emergency room. The patient had a little bleeding that stopped spontaneously. Which of the following is the next step? a. order an enzyme-linked immunosorbent assay (ELISA) test ASAP b. recommend a tetanus booster in 1 week c. offer the patient Hepatitis B immunoglobulin d. order a chest xray correct anwer- a An elderly woman has been on digoxin for 10 years. Her EKG is showing a new onset of atrial fibrillation. Her pulse is 64. She denies syncope and dizziness. Which of the following interventions is most appropriate? a. order an electrolyte panel and dig level b. order a serum thyroid-stimulating hormone, dig level, and an electrolyte panel c. order a serum dig level and decrease her digoxin dose in half while you wait on the results d. discontinue digoxin and order another 12 lead EKG correct anwer- b