Family Nurse Practitioner Q&A Flashcards
Which of the following is used to screen for color blindness in a 7-year-old boy?
A. Snellen chart
B. Ishihara chart
C. Cover/uncover test
D. Red Reflex - (Right Answers)B. Ishihara chart
The ishihara chart (or ishihara color test) is used to evaluate color blindness and can be used in
patients ranging from school-aged children to adults. It displays colored numbers with different
colored dots on the background. A pediatric color vision test for preschool children (3-6 years of
age) uses shapes instead of numbers.
A 70-year-old male patient complains of a bright-red-colored spot that has been present in his
left eye for 2 days. He denies eye pain, visual changes, or headaches. He has a new-onset cough
from a recent viral upper respiratory infection. The only medicine he is taking is Bayer aspirin 1
tablet a day. Which of the following actions is appropriate follow-up for this 70-year-old patient?
A. Refer the patient to an optometrist
B. Refer the patient to an ophthalmologist
C. Advise the patient that the condition is benign and will resolve spontaneously
D. prescribe an ophthalmic antibiotic solution - (Right Answers)C. Advise the patient that the
condition is benign and will resolve spontaneously. Subconjunctival hemorrhages do not require
any treatment. The blood in the eye will be absorbed within 10 to 14 days.
Which of the following is an accurate description of eliciting Murphy's sign?
A. On deep inspiration by the patient, palpate firmly in the right upper quadrant of the
abdomen below the costovertebral angle.
B. Bend the patient's hips and knees at 90 degrees, then passively rotate the hip externally, and
internally.
C. Ask the patient to squat, then place the stethoscope on the apical area.
,D. Press into the abdomen deeply, then release it suddenly. - (Right Answers)A. On deep
inspiration by the patient, palpate firmly in the right upper quadrant of the abdomen below the
costovertebral angle.
Murphy's sign is tested during an abdominal examination for biliary disorders. As the patient
breathes in, the abdominal contents are pushed downward as the diaphragm moves down and
the lungs expand. As the patient stops/hold the breath, the gallbladder comes in contact with
the examiner's fingers and may elicit pain. To be considered positive, the same maneuver must
not elicit pain when performed on the left side. A negative Murphy's test in the elderly is not
useful for ruling out cholecystitis if history and other tests suggest the diagnosis.
A middle-aged woman who works in the housekeeping department of a hospital presents to the
employee health clinic with a complaint of a needlestick too her left thumb. The needle was in
one of the garbage bags from the emergency department. 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, as soon as possible.
B. Recommend a tetanus booster in 1 week.
C. Offer the patient hepatitis B immunoglobulin.
D. Order a chest x-ray - (Right Answers)A. order an enzyme-linked immunosorbent assay (ELISA)
test as soon as possible
Employee health clinic protocols for needlesticks recommend ordering an ELISA test as soon as
possible to establish baseline blood work for the employee.
A 22-year-old sexually active woman is complaining of amenorrhea and new-onset bloody
vaginal spotting. On examination, her left adnexa is tender and cervical motion tenderness is
positive. Which test should the nurse practitioner order initially?
A. Flat plate of the abdomen
B. Complete blood count (CBC) with with cell differential.
C. Urine pregnancy test.
D. pelvic ultrasound. - (Right Answers)C. Urine Pregnancy Test
The patient's history of amenorrhea and new onset of bloody vaginal spotting combined with
positive physical findings of left adnexal tenderness and cervical motion tenderness are highly
, suggestive of an ectopic pregnancy rather than pelvic inflammatory disease (PID). Refer this
patient to the emergency department if ectopic pregnancy is suspected. The presence of
amenorrhea should be treated as a pregnancy until proven otherwise.
You can determine a pulse deficit by counting the:
A. Apical and radial pulses at the same time, then finding the difference between the two
B. Apical pulse first, then the radial pulse, and subtracting to find the difference between the
two.
C. Apical pulse and the femoral pulse at the same time and finding the difference between the
two.
D. Radial pulse first, then counting the femoral pulse and subtracting to find the difference
between the two. - (Right Answers)A. Apical and radial pulses at the same time, then finding the
difference between the two.
The pulse deficit is the difference between the apical pulse and the radial pulse. These should
be taken at the same time, which will require that two people take the pulse: one with a
stethoscope and one at the wrist. Count for 1 full minute. Then subtract the radial from the
apical.
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. Obtain a complete and thorough history
B. Recommend an oral antihistamine such as diphenhydramine 25 mg po QID
C. Give an injection of epinephrine 1:1000 intramuscularly STAT.
D. Call 911 - (Right Answers)A. Obtain a complete and through history
Before prescribing medications, a through history must be obtained to determine possible
causes of hives. The patient denied difficulty with swallowing and breathing, so there was no
medical emergency that would require calling 911.
Which of the following is used to screen for color blindness in a 7-year-old boy?
A. Snellen chart
B. Ishihara chart
C. Cover/uncover test
D. Red Reflex - (Right Answers)B. Ishihara chart
The ishihara chart (or ishihara color test) is used to evaluate color blindness and can be used in
patients ranging from school-aged children to adults. It displays colored numbers with different
colored dots on the background. A pediatric color vision test for preschool children (3-6 years of
age) uses shapes instead of numbers.
A 70-year-old male patient complains of a bright-red-colored spot that has been present in his
left eye for 2 days. He denies eye pain, visual changes, or headaches. He has a new-onset cough
from a recent viral upper respiratory infection. The only medicine he is taking is Bayer aspirin 1
tablet a day. Which of the following actions is appropriate follow-up for this 70-year-old patient?
A. Refer the patient to an optometrist
B. Refer the patient to an ophthalmologist
C. Advise the patient that the condition is benign and will resolve spontaneously
D. prescribe an ophthalmic antibiotic solution - (Right Answers)C. Advise the patient that the
condition is benign and will resolve spontaneously. Subconjunctival hemorrhages do not require
any treatment. The blood in the eye will be absorbed within 10 to 14 days.
Which of the following is an accurate description of eliciting Murphy's sign?
A. On deep inspiration by the patient, palpate firmly in the right upper quadrant of the
abdomen below the costovertebral angle.
B. Bend the patient's hips and knees at 90 degrees, then passively rotate the hip externally, and
internally.
C. Ask the patient to squat, then place the stethoscope on the apical area.
,D. Press into the abdomen deeply, then release it suddenly. - (Right Answers)A. On deep
inspiration by the patient, palpate firmly in the right upper quadrant of the abdomen below the
costovertebral angle.
Murphy's sign is tested during an abdominal examination for biliary disorders. As the patient
breathes in, the abdominal contents are pushed downward as the diaphragm moves down and
the lungs expand. As the patient stops/hold the breath, the gallbladder comes in contact with
the examiner's fingers and may elicit pain. To be considered positive, the same maneuver must
not elicit pain when performed on the left side. A negative Murphy's test in the elderly is not
useful for ruling out cholecystitis if history and other tests suggest the diagnosis.
A middle-aged woman who works in the housekeeping department of a hospital presents to the
employee health clinic with a complaint of a needlestick too her left thumb. The needle was in
one of the garbage bags from the emergency department. 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, as soon as possible.
B. Recommend a tetanus booster in 1 week.
C. Offer the patient hepatitis B immunoglobulin.
D. Order a chest x-ray - (Right Answers)A. order an enzyme-linked immunosorbent assay (ELISA)
test as soon as possible
Employee health clinic protocols for needlesticks recommend ordering an ELISA test as soon as
possible to establish baseline blood work for the employee.
A 22-year-old sexually active woman is complaining of amenorrhea and new-onset bloody
vaginal spotting. On examination, her left adnexa is tender and cervical motion tenderness is
positive. Which test should the nurse practitioner order initially?
A. Flat plate of the abdomen
B. Complete blood count (CBC) with with cell differential.
C. Urine pregnancy test.
D. pelvic ultrasound. - (Right Answers)C. Urine Pregnancy Test
The patient's history of amenorrhea and new onset of bloody vaginal spotting combined with
positive physical findings of left adnexal tenderness and cervical motion tenderness are highly
, suggestive of an ectopic pregnancy rather than pelvic inflammatory disease (PID). Refer this
patient to the emergency department if ectopic pregnancy is suspected. The presence of
amenorrhea should be treated as a pregnancy until proven otherwise.
You can determine a pulse deficit by counting the:
A. Apical and radial pulses at the same time, then finding the difference between the two
B. Apical pulse first, then the radial pulse, and subtracting to find the difference between the
two.
C. Apical pulse and the femoral pulse at the same time and finding the difference between the
two.
D. Radial pulse first, then counting the femoral pulse and subtracting to find the difference
between the two. - (Right Answers)A. Apical and radial pulses at the same time, then finding the
difference between the two.
The pulse deficit is the difference between the apical pulse and the radial pulse. These should
be taken at the same time, which will require that two people take the pulse: one with a
stethoscope and one at the wrist. Count for 1 full minute. Then subtract the radial from the
apical.
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. Obtain a complete and thorough history
B. Recommend an oral antihistamine such as diphenhydramine 25 mg po QID
C. Give an injection of epinephrine 1:1000 intramuscularly STAT.
D. Call 911 - (Right Answers)A. Obtain a complete and through history
Before prescribing medications, a through history must be obtained to determine possible
causes of hives. The patient denied difficulty with swallowing and breathing, so there was no
medical emergency that would require calling 911.
