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1. During a vision assessment using the Snellen chart, the nurse practitioner records 20/30 vision
in the left eye and 20/40 in the right eye. What should be the next step?
a) Schedule a follow-up vision test in two weeks.
b) Perform eye dilation before retesting.
c) Refer the patient to an ophthalmologist
d) Note this as normal vision.
2. According to the Diagnostic and Statistical Manual of Mental Disorders by the American
Psychiatric Association, Munchausen Syndrome by Proxy is identified as:
a) Self-inflicted harm for attention.
b) A caregiver making up or causing an illness or injury in a person under his or her care
c) Abuse not involving the caregiver.
d) Neglectful behavior from the abuser towards the victim.
Munchausen syndrome by proxy involves a caregiver, often the mother, creating or exaggerating
symptoms in a child to appear ill.
3. Which medication linked to neurotransmitter activity can cause depression as a side effect?
a) Dopamine
b) Gabapentin
c) Mil
d) Cortisol
,4. Identify the lesion that is elevated, dark, asymmetrical, and has an irregular border:
a) Nevus
b) Actinic keratosis
c) Keratoacanthoma
d) Melanoma
5. A 32-year-old female reports dull puffiness around the eyes without pitting periorbital edema.
Which condition does this suggest?
a) Nephrotic syndrome
b) Myxedema
c) Cushing syndrome
d) Sinusitis
Myxedema involves mucopolysaccharide accumulation in the dermis, often seen with advanced
hypothyroidism, including facial and skin swelling.
6. For a 42-year-old female seeking preventive treatment for migraine headaches, which
medication is advisable?
a) Sumatriptan (Imitrex)
b) Amitriptyline (Elavil)
c) Verapamil (Verelan)
d) Metoprolol (Lopressor)
Amitriptyline (Elavil) is used off-label for migraine prophylaxis.
,7. Scalp scaling and circular alopecia patches in a pediatric patient likely indicate:
a) Tinea capitis
b) Seborrheic dermatitis
c) Trichotillomania
d) Alopecia areata
8. The most suitable preventive migraine medication for an 18-year-old female with a history of
migraines is:
a) Sumatriptan (Imitrex)
b) Propranolol (Inderal)
c) Ibuprofen (Motrin)
d) Dihydroergotamine (DHE)
9. What reason makes combined hormonal contraceptives a poor choice for a 36-year-old woman
with type 2 diabetes, obesity, chronic smoking, and a sedentary lifestyle?
a) Obesity
b) Type 2 diabetes
c) Her age and smoking habits
d) Sedentary lifestyle
Combined oral contraceptives are not recommended for women over 45, smokers, those with
hypertension, diabetes, or a history of stroke.
10. A bloody and spontaneous nipple discharge detected during a breast exam of a
perimenopausal woman necessitates further investigation. This symptom could indicate:
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a) Fibroadenoma
b) Polycystic breast disease
c) An intraductal papilloma
d) Pituitary prolactinoma
Intraductal papillomas are small, often under 1 cm, and prone to bleeding.
11. At what point in pregnancy should Rh-negative women be administered Rho (D)
immunoglobulin?
a) 6 weeks
b) 12 weeks
c) 28 weeks
d) 35 weeks
If an Rh-negative client shows a negative antibody screen, she will need ongoing antibody
screenings and must receive Rho(D) immunoglobulin (RhoGAM) at 28 weeks of pregnancy.
12. In a complete blood count (CBC), which parameter indicates the average size of red blood
cells (RBCs)?
a) Hemoglobin
b) Mean corpuscular volume (MCV)
c) Red cell distribution width (RDW)
d) Hematocrit
The mean corpuscular volume (MCV) measures the average size of RBCs. A lower MCV
indicates smaller RBCs, while a higher MCV indicates larger RBCs.