NR667 Week 1 Actual Exam Style V2 | NR
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. Which of the following criteria is necessary to bill for a 99214 level of service for an
established patient?
A. At least two of three components: Detailed history, detailed exam, or moderate
complexity MDM.
B. A comprehensive history and a comprehensive physical examination.
C. A problem-focused history and exam with straightforward medical decision making.
D. Meeting all three components of history, exam, and medical decision making.
Answer: A
Rationale: To bill a 99214 for an established patient, the clinician must document at least
two of the three key components. These components include a detailed history, a detailed
physical examination, and medical decision-making of moderate complexity. Proper coding
ensures the clinic remains compliant with CMS guidelines while capturing the complexity
of the visit.
2. A 65-year-old male with no history of diabetes has a blood pressure of 152/94 mmHg.
According to JNC-8 guidelines, what is the target blood pressure for this patient?
A. < 150/90 mmHg
,B. < 140/90 mmHg
C. < 130/80 mmHg
D. < 120/70 mmHg
Answer: A
Rationale: JNC-8 guidelines recommend a target blood pressure of less than 150/90
mmHg for adults aged 60 years or older without diabetes or chronic kidney disease. This
recommendation was based on evidence showing that more aggressive targets did not
provide additional benefit in this specific age group. Treatment should focus on lifestyle
modifications and pharmacological therapy if targets are not met.
3. According to the USPSTF, at what age should routine screening for colorectal cancer begin
for adults with average risk?
A. 45 years
B. 40 years
C. 50 years
D. 55 years
Answer: A
Rationale: The USPSTF updated its guidelines to recommend that colorectal cancer
screening begin at age 45 for adults with average risk. This change was implemented due to
, the rising incidence of colorectal cancer in younger populations. Screening can be
performed via stool-based tests or direct visualization procedures like colonoscopies.
4. A patient presents with a ‘stuck-on’ appearance lesion that is waxy, brown, and well-
circumscribed. This most likely represents:
A. Seborrheic keratosis
B. Basal cell carcinoma
C. Actinic keratosis
D. Malignant melanoma
Answer: A
Rationale: Seborrheic keratosis is a benign skin lesion characterized by a waxy, ‘stuck-on’
appearance. These lesions are very common in older adults and can vary in color from tan
to black. They do not require treatment unless they become irritated or the patient desires
removal for cosmetic reasons.
5. Which of the following is considered the first-line treatment for a patient newly diagnosed
with Type 2 Diabetes and an A1c of 7.5%?
A. Metformin
B. Glipizide
C. Insulin Glargine
D. Pioglitazone
667 FNP Capstone Practicum and
Intensive CEA | Chamberlain
1. Which of the following criteria is necessary to bill for a 99214 level of service for an
established patient?
A. At least two of three components: Detailed history, detailed exam, or moderate
complexity MDM.
B. A comprehensive history and a comprehensive physical examination.
C. A problem-focused history and exam with straightforward medical decision making.
D. Meeting all three components of history, exam, and medical decision making.
Answer: A
Rationale: To bill a 99214 for an established patient, the clinician must document at least
two of the three key components. These components include a detailed history, a detailed
physical examination, and medical decision-making of moderate complexity. Proper coding
ensures the clinic remains compliant with CMS guidelines while capturing the complexity
of the visit.
2. A 65-year-old male with no history of diabetes has a blood pressure of 152/94 mmHg.
According to JNC-8 guidelines, what is the target blood pressure for this patient?
A. < 150/90 mmHg
,B. < 140/90 mmHg
C. < 130/80 mmHg
D. < 120/70 mmHg
Answer: A
Rationale: JNC-8 guidelines recommend a target blood pressure of less than 150/90
mmHg for adults aged 60 years or older without diabetes or chronic kidney disease. This
recommendation was based on evidence showing that more aggressive targets did not
provide additional benefit in this specific age group. Treatment should focus on lifestyle
modifications and pharmacological therapy if targets are not met.
3. According to the USPSTF, at what age should routine screening for colorectal cancer begin
for adults with average risk?
A. 45 years
B. 40 years
C. 50 years
D. 55 years
Answer: A
Rationale: The USPSTF updated its guidelines to recommend that colorectal cancer
screening begin at age 45 for adults with average risk. This change was implemented due to
, the rising incidence of colorectal cancer in younger populations. Screening can be
performed via stool-based tests or direct visualization procedures like colonoscopies.
4. A patient presents with a ‘stuck-on’ appearance lesion that is waxy, brown, and well-
circumscribed. This most likely represents:
A. Seborrheic keratosis
B. Basal cell carcinoma
C. Actinic keratosis
D. Malignant melanoma
Answer: A
Rationale: Seborrheic keratosis is a benign skin lesion characterized by a waxy, ‘stuck-on’
appearance. These lesions are very common in older adults and can vary in color from tan
to black. They do not require treatment unless they become irritated or the patient desires
removal for cosmetic reasons.
5. Which of the following is considered the first-line treatment for a patient newly diagnosed
with Type 2 Diabetes and an A1c of 7.5%?
A. Metformin
B. Glipizide
C. Insulin Glargine
D. Pioglitazone
