FNP 654 Family Primary Care II Final Exam Prep |Actual
Comprehensive Q&As with Detailed Rationales LATEST UPDATED
THIS YEAR INSTANT PDF DOWNLOAD
Section 1: Neurology and Musculoskeletal Disorders
1. A sixty-two-year-old male presents with asymmetric resting tremor, muscle rigidity,
and bradykinesia. Which neurotransmitter deficiency is primarily responsible for this
clinical presentation?
o A) Acetylcholine
o B) Dopamine
o C) Gamma-aminobutyric acid (GABA)
o D) Serotonin
Parkinson's disease is characterized by the progressive loss of dopamine-producing
neurons in the substantia nigra, leading to the classic triad of motor symptoms.
2. A patient presenting with sudden, severe unilateral facial paralysis is diagnosed with
Bell's Palsy. Which cranial nerve is affected in this condition?
o A) Cranial Nerve V
o B) Cranial Nerve VII
o C) Cranial Nerve VIII
o D) Cranial Nerve X
Bell's Palsy is an acute peripheral facial nerve palsy involving the facial nerve (Cranial
Nerve VII), causing paralysis of all facial expression muscles on the affected side.
, 3. A patient presents with acute, ascending muscle weakness and paresthesias
following a recent diarrheal illness. Which condition is most highly suspected based
on this clinical history?
o A) Multiple Sclerosis
o B) Guillain-Barré Syndrome
o C) Myasthenia Gravis
o D) Amyotrophic Lateral Sclerosis
Guillain-Barré Syndrome is an acute, demyelinating polyneuropathy often preceded by an
infection like Campylobacter jejuni, presenting as progressive, ascending flaccid paralysis.
4. An adult patient presents with episodic, unilateral, throbbing headache accompanied
by photophobia, phonophobia, and a visual aura. What is the most appropriate first-
line abortive therapy?
o A) Sumatriptan
o B) Propranolol
o C) Amitriptyline
o D) Topiramate
Triptans, such as Sumatriptan, are selective 5-HT1B/1D receptor agonists and serve as
first-line abortive therapy for moderate-to-severe migraine attacks.
5. A patient with known epilepsy is experiencing a continuous seizure lasting longer
than five minutes. Which class of medication is the immediate first-line treatment?
o A) Phenytoin
o B) Valproic Acid
, o C) Levetiracetam
o D) Benzodiazepines
Intravenous or intramuscular benzodiazepines (such as Lorazepam or Midazolam) are the
immediate first-line choice to terminate status epilepticus.
6. A seventy-year-old female presents with severe, unilateral headache, jaw
claudication, and visual changes. What is the most critical immediate diagnostic and
therapeutic action?
o A) Order an outpatient MRI and start ibuprofen
o B) Administer high-dose oral corticosteroids and arrange for a temporal
artery biopsy
o C) Prescribe low-dose aspirin and schedule a neurology consult
o D) Initiate triptan therapy for atypical migraine headache
These symptoms strongly suggest Giant Cell Arteritis (temporal arteritis). Immediate high-
dose systemic corticosteroids are vital to prevent irreversible blindness while awaiting
biopsy confirmation.
7. A patient presents with intense, unilateral, electric shock-like facial pain triggered by
brushing teeth and talking. Which cranial nerve is involved in this pathology?
o A) Cranial Nerve VII
o B) Cranial Nerve V
o C) Cranial Nerve IX
o D) Cranial Nerve XI
, Trigeminal neuralgia involves the trigeminal nerve (Cranial Nerve V), causing paroxysmal,
severe, stabbing pain in one or more branches of the nerve.
8. A patient is evaluated for progressive weakness that worsens with repetitive muscle
use and improves with rest. Which confirmatory diagnostic finding supports
Myasthenia Gravis?
o A) Decreased cerebrospinal fluid protein
o B) Positive acetylcholine receptor antibodies
o C) Demyelination on brain MRI
o D) Elevated serum creatine kinase
Myasthenia Gravis is an autoimmune disorder caused by antibodies directed against
acetylcholine receptors at the neuromuscular junction.
9. A patient presents with acute onset of severe vertigo, nausea, and horizontal
nystagmus triggered by changing head positions. Which diagnostic maneuver
confirms benign paroxysmal positional vertigo?
o A) Romberg test
o B) McMurray test
o C) Dix-Hallpike maneuver
o D) Epley maneuver
The Dix-Hallpike maneuver is the gold standard diagnostic test used to elicit nystagmus and
vertigo in patients with suspected BPPV.
10. A patient presents with a progressive, resting hand tremor that improves with
voluntary movement and alcohol consumption. What is the correct diagnosis?
Comprehensive Q&As with Detailed Rationales LATEST UPDATED
THIS YEAR INSTANT PDF DOWNLOAD
Section 1: Neurology and Musculoskeletal Disorders
1. A sixty-two-year-old male presents with asymmetric resting tremor, muscle rigidity,
and bradykinesia. Which neurotransmitter deficiency is primarily responsible for this
clinical presentation?
o A) Acetylcholine
o B) Dopamine
o C) Gamma-aminobutyric acid (GABA)
o D) Serotonin
Parkinson's disease is characterized by the progressive loss of dopamine-producing
neurons in the substantia nigra, leading to the classic triad of motor symptoms.
2. A patient presenting with sudden, severe unilateral facial paralysis is diagnosed with
Bell's Palsy. Which cranial nerve is affected in this condition?
o A) Cranial Nerve V
o B) Cranial Nerve VII
o C) Cranial Nerve VIII
o D) Cranial Nerve X
Bell's Palsy is an acute peripheral facial nerve palsy involving the facial nerve (Cranial
Nerve VII), causing paralysis of all facial expression muscles on the affected side.
, 3. A patient presents with acute, ascending muscle weakness and paresthesias
following a recent diarrheal illness. Which condition is most highly suspected based
on this clinical history?
o A) Multiple Sclerosis
o B) Guillain-Barré Syndrome
o C) Myasthenia Gravis
o D) Amyotrophic Lateral Sclerosis
Guillain-Barré Syndrome is an acute, demyelinating polyneuropathy often preceded by an
infection like Campylobacter jejuni, presenting as progressive, ascending flaccid paralysis.
4. An adult patient presents with episodic, unilateral, throbbing headache accompanied
by photophobia, phonophobia, and a visual aura. What is the most appropriate first-
line abortive therapy?
o A) Sumatriptan
o B) Propranolol
o C) Amitriptyline
o D) Topiramate
Triptans, such as Sumatriptan, are selective 5-HT1B/1D receptor agonists and serve as
first-line abortive therapy for moderate-to-severe migraine attacks.
5. A patient with known epilepsy is experiencing a continuous seizure lasting longer
than five minutes. Which class of medication is the immediate first-line treatment?
o A) Phenytoin
o B) Valproic Acid
, o C) Levetiracetam
o D) Benzodiazepines
Intravenous or intramuscular benzodiazepines (such as Lorazepam or Midazolam) are the
immediate first-line choice to terminate status epilepticus.
6. A seventy-year-old female presents with severe, unilateral headache, jaw
claudication, and visual changes. What is the most critical immediate diagnostic and
therapeutic action?
o A) Order an outpatient MRI and start ibuprofen
o B) Administer high-dose oral corticosteroids and arrange for a temporal
artery biopsy
o C) Prescribe low-dose aspirin and schedule a neurology consult
o D) Initiate triptan therapy for atypical migraine headache
These symptoms strongly suggest Giant Cell Arteritis (temporal arteritis). Immediate high-
dose systemic corticosteroids are vital to prevent irreversible blindness while awaiting
biopsy confirmation.
7. A patient presents with intense, unilateral, electric shock-like facial pain triggered by
brushing teeth and talking. Which cranial nerve is involved in this pathology?
o A) Cranial Nerve VII
o B) Cranial Nerve V
o C) Cranial Nerve IX
o D) Cranial Nerve XI
, Trigeminal neuralgia involves the trigeminal nerve (Cranial Nerve V), causing paroxysmal,
severe, stabbing pain in one or more branches of the nerve.
8. A patient is evaluated for progressive weakness that worsens with repetitive muscle
use and improves with rest. Which confirmatory diagnostic finding supports
Myasthenia Gravis?
o A) Decreased cerebrospinal fluid protein
o B) Positive acetylcholine receptor antibodies
o C) Demyelination on brain MRI
o D) Elevated serum creatine kinase
Myasthenia Gravis is an autoimmune disorder caused by antibodies directed against
acetylcholine receptors at the neuromuscular junction.
9. A patient presents with acute onset of severe vertigo, nausea, and horizontal
nystagmus triggered by changing head positions. Which diagnostic maneuver
confirms benign paroxysmal positional vertigo?
o A) Romberg test
o B) McMurray test
o C) Dix-Hallpike maneuver
o D) Epley maneuver
The Dix-Hallpike maneuver is the gold standard diagnostic test used to elicit nystagmus and
vertigo in patients with suspected BPPV.
10. A patient presents with a progressive, resting hand tremor that improves with
voluntary movement and alcohol consumption. What is the correct diagnosis?
