,Question 1
Mr. A experienced a brief onset of right-sided weakness, slurred speech, and confusion yesterday. The
symptoms have resolved, and a CT scan is normal. What is the next step in the plan of care for Mr. A?
a. Assure the patient that he will not experience the symptoms again
b. Identify modifiable cardiovascular risk factors
c. Order aspirin (ASA) 81 mg stat
d. Order a stat EEG and administer oxygen by mask
Correct Answer: b. Identify modifiable cardiovascular risk factors
Rationale:
Mr. A’s presentation is consistent with a transient ischemic attack (TIA). Management focuses on
secondary prevention by identifying and addressing modifiable cardiovascular risk factors (e.g.,
hypertension, diabetes, smoking, hyperlipidemia) to reduce the risk of future stroke.
Question 2
A 56-year-old male patient screened for diabetes has a fasting plasma glucose level of 96 mg/dL. The
nurse practitioner’s management plan should include:
a. Repeat fasting plasma glucose in three years
b. Prescribe metformin 500 mg PO BID
c. Repeat fasting plasma glucose in one year
d. Refer to ophthalmology for eye examination
Correct Answer: a. Repeat fasting plasma glucose in three years
Rationale:
A fasting plasma glucose of 96 mg/dL is normal. For patients without risk factors, diabetes screening is
recommended every three years.
Question 3
RW, a 57-year-old Native American female, presents with irritability, difficulty concentrating, and trouble
falling and staying asleep. She reports financial stress due to her husband losing his job. The nurse
practitioner diagnoses anxiety. What is the first-line treatment?
a. Diazepam
b. Clonazepam
,c. Aripiprazole
d. Paroxetine
Correct Answer: d. Paroxetine
Rationale:
Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine are first-line treatment for anxiety
disorders. Benzodiazepines are not first-line due to risks of dependence and sedation.
Question 4
The most common sustained rhythmic disorder characterized by fibrillatory P waves is:
a. AV block
b. Atrial tachycardia
c. Atrial fibrillation
d. Atrial flutter
Correct Answer: c. Atrial fibrillation
Rationale:
Atrial fibrillation is the most common sustained arrhythmia and is characterized by irregularly irregular
rhythm and fibrillatory P waves.
Question 5
According to sexual health presentation, atrophic vaginitis:
a. Produces the same symptoms in all women
b. Creates a more acidic vaginal environment
c. Is a contributing factor to frequent urinary tract infections
d. Is not treated with vaginal lubricants
Correct Answer: c. Is a contributing factor to frequent urinary tract infections
Rationale:
Atrophic vaginitis results from estrogen deficiency, leading to thinning of the vaginal epithelium and
increased susceptibility to UTIs.
Question 6
Which of the following is the most appropriate screening tool for delirium?
a. Saint Louis University Mental Status Exam (SLUMS)
b. Montreal Cognitive Assessment (MoCA)
, c. Lawton Scale of Instrumental Activities of Daily Living
d. Confusion Assessment Method (CAM)
Correct Answer: d. Confusion Assessment Method (CAM)
Rationale:
The Confusion Assessment Method (CAM) is the most widely used and validated screening tool for
delirium, focusing on acute onset, fluctuating course, inattention, and disorganized thinking.
Question 7
Which drug can be used to treat two very common symptoms in a dying patient—pain and dyspnea?
a. Lorazepam
b. Gabapentin
c. Methadone
d. Morphine
Correct Answer: d. Morphine
Rationale:
Morphine is effective for both pain control and dyspnea in end-of-life care by reducing respiratory
distress and improving comfort.
Question 8
Which of the following would you recommend annually for an elderly patient with type 2 diabetes?
a. Periodic visits to a gastroenterologist
b. Colonoscopy
c. Follow-up with a urologist
d. Eye examination with an ophthalmologist
Correct Answer: d. Eye examination with an ophthalmologist
Rationale:
Annual dilated eye examinations are recommended for diabetic patients to screen for diabetic
retinopathy and prevent vision loss.
Question 9
Which characteristic of delirium helps distinguish it from dementia?
a. Short-term memory impairment
b. Personality changes
Mr. A experienced a brief onset of right-sided weakness, slurred speech, and confusion yesterday. The
symptoms have resolved, and a CT scan is normal. What is the next step in the plan of care for Mr. A?
a. Assure the patient that he will not experience the symptoms again
b. Identify modifiable cardiovascular risk factors
c. Order aspirin (ASA) 81 mg stat
d. Order a stat EEG and administer oxygen by mask
Correct Answer: b. Identify modifiable cardiovascular risk factors
Rationale:
Mr. A’s presentation is consistent with a transient ischemic attack (TIA). Management focuses on
secondary prevention by identifying and addressing modifiable cardiovascular risk factors (e.g.,
hypertension, diabetes, smoking, hyperlipidemia) to reduce the risk of future stroke.
Question 2
A 56-year-old male patient screened for diabetes has a fasting plasma glucose level of 96 mg/dL. The
nurse practitioner’s management plan should include:
a. Repeat fasting plasma glucose in three years
b. Prescribe metformin 500 mg PO BID
c. Repeat fasting plasma glucose in one year
d. Refer to ophthalmology for eye examination
Correct Answer: a. Repeat fasting plasma glucose in three years
Rationale:
A fasting plasma glucose of 96 mg/dL is normal. For patients without risk factors, diabetes screening is
recommended every three years.
Question 3
RW, a 57-year-old Native American female, presents with irritability, difficulty concentrating, and trouble
falling and staying asleep. She reports financial stress due to her husband losing his job. The nurse
practitioner diagnoses anxiety. What is the first-line treatment?
a. Diazepam
b. Clonazepam
,c. Aripiprazole
d. Paroxetine
Correct Answer: d. Paroxetine
Rationale:
Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine are first-line treatment for anxiety
disorders. Benzodiazepines are not first-line due to risks of dependence and sedation.
Question 4
The most common sustained rhythmic disorder characterized by fibrillatory P waves is:
a. AV block
b. Atrial tachycardia
c. Atrial fibrillation
d. Atrial flutter
Correct Answer: c. Atrial fibrillation
Rationale:
Atrial fibrillation is the most common sustained arrhythmia and is characterized by irregularly irregular
rhythm and fibrillatory P waves.
Question 5
According to sexual health presentation, atrophic vaginitis:
a. Produces the same symptoms in all women
b. Creates a more acidic vaginal environment
c. Is a contributing factor to frequent urinary tract infections
d. Is not treated with vaginal lubricants
Correct Answer: c. Is a contributing factor to frequent urinary tract infections
Rationale:
Atrophic vaginitis results from estrogen deficiency, leading to thinning of the vaginal epithelium and
increased susceptibility to UTIs.
Question 6
Which of the following is the most appropriate screening tool for delirium?
a. Saint Louis University Mental Status Exam (SLUMS)
b. Montreal Cognitive Assessment (MoCA)
, c. Lawton Scale of Instrumental Activities of Daily Living
d. Confusion Assessment Method (CAM)
Correct Answer: d. Confusion Assessment Method (CAM)
Rationale:
The Confusion Assessment Method (CAM) is the most widely used and validated screening tool for
delirium, focusing on acute onset, fluctuating course, inattention, and disorganized thinking.
Question 7
Which drug can be used to treat two very common symptoms in a dying patient—pain and dyspnea?
a. Lorazepam
b. Gabapentin
c. Methadone
d. Morphine
Correct Answer: d. Morphine
Rationale:
Morphine is effective for both pain control and dyspnea in end-of-life care by reducing respiratory
distress and improving comfort.
Question 8
Which of the following would you recommend annually for an elderly patient with type 2 diabetes?
a. Periodic visits to a gastroenterologist
b. Colonoscopy
c. Follow-up with a urologist
d. Eye examination with an ophthalmologist
Correct Answer: d. Eye examination with an ophthalmologist
Rationale:
Annual dilated eye examinations are recommended for diabetic patients to screen for diabetic
retinopathy and prevent vision loss.
Question 9
Which characteristic of delirium helps distinguish it from dementia?
a. Short-term memory impairment
b. Personality changes
