FNP FINAL EXAM NEWEST VERSION ACTUAL 135 QUESTION
AND CORRECT DETAILED VERIFIED ANSWERS FROM VERIFIED
SOURCES BY EXPERT RATED A GRADE. FNP ACTUAL EXAM
FINAL!!!!!
FNP FINAL EXAM NEWEST VERSION ACTUAL 135 QUESTION AND CORRECT
DETAILED VERIFIED ANSWERS FROM VERIFIED SOURCES BY EXPERT RATED A
GRADE. FNP ACTUAL EXAM FINAL!!!!!
A 13-year-old child has exhibited symptoms of mild depression for several weeks. The
parent reports feeling relieved that the symptoms have passed but concerned that the
child now seems to have boundless energy and an inability to sit still. What will the
primary care pediatric nurse practitioner do?
A. Administer an ADHD diagnostic scale and consider an ADHD medication.
B. Consult with a child psychiatrist to prescribe an antidepressant medication.
C. Reassure the parent that this behavior is common after mild depressive symptoms.
D. Refer the child to a child psychiatrist for evaluation of bipolar disorder.
CORRECT ANS: D
Expert Rationale
The clinical picture described—a transition from depressive symptoms to a state
characterized by boundless energy, hyperactivity, and an inability to remain still—is
highly concerning for a possible manic or hypomanic episode. In the pediatric
population, the emergence of such symptoms following a period of depression is a
classic presentation of bipolar disorder, particularly Bipolar I or II disorder. The
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a manic
episode include a distinct period of abnormally and persistently elevated, expansive, or
irritable mood and abnormally and persistently increased goal-directed activity or
energy, lasting at least one week. The child's "boundless energy" and "inability to sit
still" are cardinal features of this presentation. This is a significant psychiatric emergency
that requires immediate and specialized evaluation. The primary care pediatric nurse
practitioner's role is to recognize the red flags, ensure the child's safety, and facilitate a
prompt referral to a child psychiatrist. A child psychiatrist is uniquely qualified to
conduct a comprehensive diagnostic evaluation, differentiate between bipolar disorder
and other conditions (such as ADHD), and initiate appropriate mood-stabilizing therapy.
,Administering an ADHD scale or prescribing medication for ADHD would be
inappropriate and potentially harmful, as stimulants can precipitate or exacerbate mania.
Consulting with a psychiatrist to prescribe an antidepressant is also inappropriate, as
antidepressants can induce mania or rapid cycling in patients with bipolar disorder.
Reassuring the parents that this is normal would be negligent and dangerous given the
severity and nature of the symptoms.
DIF: Cognitive Level: Analyze (Analysis) TOP: Pediatric Mental Health
MSC: NCLEX: Psychosocial Integrity
A 35-year-old patient reports suddenly experiencing an asymmetric smile along with
drooping and tearing in one eye. The patient has a history of a recent viral illness but is
otherwise healthy. During the exam, the provider notes that there is unilateral full-face
paralysis on the right side. What is the initial intervention for this patient?
a. Perform confirmatory diagnostic tests
b. Prescribe oral prednisolone
c. Recommend wearing an eye patch
d. Refer the patient to a neurologist
CORRECT ANS: b
Expert Rationale
The patient's presentation—acute onset of unilateral, full-face paralysis following a viral
illness—is highly consistent with Bell's palsy, an idiopathic peripheral facial nerve palsy.
Bell's palsy is the most common cause of acute facial nerve paralysis and is believed to
be due to inflammation and edema of the facial nerve, often triggered by a viral
infection such as herpes simplex virus. The initial intervention, as supported by clinical
practice guidelines, is the prompt initiation of a short course of high-dose oral
corticosteroids, such as prednisolone. Corticosteroids reduce inflammation and edema
of the facial nerve, thereby improving the likelihood of complete recovery and
minimizing the risk of long-term sequelae. This treatment is most effective when
initiated within 72 hours of symptom onset. While the diagnosis is primarily clinical, and
further testing may not be necessary for typical presentations, the immediate priority is
initiating corticosteroid therapy. An eye patch (option c) or lubricating eye drops are
important adjunctive measures to prevent corneal abrasion due to incomplete eye
closure, but they are not the primary intervention. A neurologist referral (option d) may
,be considered for atypical presentations or if there is no improvement, but it is not the
initial action. Performing confirmatory diagnostic tests (option a) should not delay the
initiation of steroids, as they are the standard of care.
DIF: Cognitive Level: Apply (Application) TOP: Neurological Disorders
MSC: NCLEX: Physiological Integrity
A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The
provider determines that these symptoms occur in relation to many events and
concerns. What other things will the provider question this patient about?
a. Ability to manage social situations
b. Body image and eating habits
c. Headaches and bowel habits
d. Occupational performance
CORRECT ANS: c
Expert Rationale
The patient's symptoms of restlessness, fatigue, and difficulty concentrating that occur
in relation to "many events and concerns" suggest a diagnosis of generalized anxiety
disorder (GAD). GAD is characterized by excessive, uncontrollable worry about various
aspects of daily life, accompanied by physical and cognitive symptoms such as those
described. When evaluating a patient for GAD, it is important to assess for somatic
complaints that frequently accompany anxiety disorders. Headaches and bowel habit
disturbances (such as irritable bowel syndrome) are common somatic manifestations of
chronic anxiety. The gut-brain axis and the physiological effects of chronic stress often
manifest as gastrointestinal symptoms. A comprehensive assessment should also
include questions about sleep, muscle tension, and other physical symptoms. While
assessing social functioning (option a), occupational performance (option d), and body
image (option b) may be relevant in a broader psychosocial evaluation, they are not the
most specific or common physical manifestations of GAD. The provider should prioritize
exploring somatic symptoms that are frequently associated with anxiety.
DIF: Cognitive Level: Apply (Application) TOP: Mental Health
MSC: NCLEX: Psychosocial Integrity
, The spouse of a patient newly diagnosed with amyotrophic lateral sclerosis (ALS) asks
about long-term care. What will the provider include when teaching the family about
this disease?
a. Bowel and bladder function will eventually be lost
b. Positive-pressure ventilation can prolong life.
c. Preventing malnutrition is a key element in care.
d. The nerves affecting sensation will die initially.
CORRECT ANS: c
Expert Rationale
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that
affects both upper and lower motor neurons, leading to muscle weakness, atrophy, and
spasticity. While the disease eventually affects all voluntary muscles, leading to
respiratory failure and death, it spares cognitive function and sensory nerves. A critical
aspect of care in ALS is preventing malnutrition. As the disease progresses, patients
develop dysphagia and difficulty swallowing, which can lead to inadequate caloric
intake, weight loss, and malnutrition. Malnutrition contributes to muscle wasting,
weakness, and decreased immune function. Therefore, early nutritional assessment and
intervention, including the use of thickened liquids, high-calorie supplements, and
eventually enteral feeding (e.g., percutaneous endoscopic gastrostomy tube), are
essential. Option a is incorrect; bowel and bladder function are typically preserved in
ALS. Option b is partially true but is not the most important element of long-term care;
positive-pressure ventilation (non-invasive ventilation or tracheostomy) can prolong life,
but it is a later intervention. Option d is incorrect; ALS primarily affects motor nerves, not
sensory nerves, so sensation is generally intact.
DIF: Cognitive Level: Understand (Comprehension) TOP: Neurological Disorders
MSC: NCLEX: Physiological Integrity
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?
a. Acupuncture
b. Lubricating eye drops
AND CORRECT DETAILED VERIFIED ANSWERS FROM VERIFIED
SOURCES BY EXPERT RATED A GRADE. FNP ACTUAL EXAM
FINAL!!!!!
FNP FINAL EXAM NEWEST VERSION ACTUAL 135 QUESTION AND CORRECT
DETAILED VERIFIED ANSWERS FROM VERIFIED SOURCES BY EXPERT RATED A
GRADE. FNP ACTUAL EXAM FINAL!!!!!
A 13-year-old child has exhibited symptoms of mild depression for several weeks. The
parent reports feeling relieved that the symptoms have passed but concerned that the
child now seems to have boundless energy and an inability to sit still. What will the
primary care pediatric nurse practitioner do?
A. Administer an ADHD diagnostic scale and consider an ADHD medication.
B. Consult with a child psychiatrist to prescribe an antidepressant medication.
C. Reassure the parent that this behavior is common after mild depressive symptoms.
D. Refer the child to a child psychiatrist for evaluation of bipolar disorder.
CORRECT ANS: D
Expert Rationale
The clinical picture described—a transition from depressive symptoms to a state
characterized by boundless energy, hyperactivity, and an inability to remain still—is
highly concerning for a possible manic or hypomanic episode. In the pediatric
population, the emergence of such symptoms following a period of depression is a
classic presentation of bipolar disorder, particularly Bipolar I or II disorder. The
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a manic
episode include a distinct period of abnormally and persistently elevated, expansive, or
irritable mood and abnormally and persistently increased goal-directed activity or
energy, lasting at least one week. The child's "boundless energy" and "inability to sit
still" are cardinal features of this presentation. This is a significant psychiatric emergency
that requires immediate and specialized evaluation. The primary care pediatric nurse
practitioner's role is to recognize the red flags, ensure the child's safety, and facilitate a
prompt referral to a child psychiatrist. A child psychiatrist is uniquely qualified to
conduct a comprehensive diagnostic evaluation, differentiate between bipolar disorder
and other conditions (such as ADHD), and initiate appropriate mood-stabilizing therapy.
,Administering an ADHD scale or prescribing medication for ADHD would be
inappropriate and potentially harmful, as stimulants can precipitate or exacerbate mania.
Consulting with a psychiatrist to prescribe an antidepressant is also inappropriate, as
antidepressants can induce mania or rapid cycling in patients with bipolar disorder.
Reassuring the parents that this is normal would be negligent and dangerous given the
severity and nature of the symptoms.
DIF: Cognitive Level: Analyze (Analysis) TOP: Pediatric Mental Health
MSC: NCLEX: Psychosocial Integrity
A 35-year-old patient reports suddenly experiencing an asymmetric smile along with
drooping and tearing in one eye. The patient has a history of a recent viral illness but is
otherwise healthy. During the exam, the provider notes that there is unilateral full-face
paralysis on the right side. What is the initial intervention for this patient?
a. Perform confirmatory diagnostic tests
b. Prescribe oral prednisolone
c. Recommend wearing an eye patch
d. Refer the patient to a neurologist
CORRECT ANS: b
Expert Rationale
The patient's presentation—acute onset of unilateral, full-face paralysis following a viral
illness—is highly consistent with Bell's palsy, an idiopathic peripheral facial nerve palsy.
Bell's palsy is the most common cause of acute facial nerve paralysis and is believed to
be due to inflammation and edema of the facial nerve, often triggered by a viral
infection such as herpes simplex virus. The initial intervention, as supported by clinical
practice guidelines, is the prompt initiation of a short course of high-dose oral
corticosteroids, such as prednisolone. Corticosteroids reduce inflammation and edema
of the facial nerve, thereby improving the likelihood of complete recovery and
minimizing the risk of long-term sequelae. This treatment is most effective when
initiated within 72 hours of symptom onset. While the diagnosis is primarily clinical, and
further testing may not be necessary for typical presentations, the immediate priority is
initiating corticosteroid therapy. An eye patch (option c) or lubricating eye drops are
important adjunctive measures to prevent corneal abrasion due to incomplete eye
closure, but they are not the primary intervention. A neurologist referral (option d) may
,be considered for atypical presentations or if there is no improvement, but it is not the
initial action. Performing confirmatory diagnostic tests (option a) should not delay the
initiation of steroids, as they are the standard of care.
DIF: Cognitive Level: Apply (Application) TOP: Neurological Disorders
MSC: NCLEX: Physiological Integrity
A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The
provider determines that these symptoms occur in relation to many events and
concerns. What other things will the provider question this patient about?
a. Ability to manage social situations
b. Body image and eating habits
c. Headaches and bowel habits
d. Occupational performance
CORRECT ANS: c
Expert Rationale
The patient's symptoms of restlessness, fatigue, and difficulty concentrating that occur
in relation to "many events and concerns" suggest a diagnosis of generalized anxiety
disorder (GAD). GAD is characterized by excessive, uncontrollable worry about various
aspects of daily life, accompanied by physical and cognitive symptoms such as those
described. When evaluating a patient for GAD, it is important to assess for somatic
complaints that frequently accompany anxiety disorders. Headaches and bowel habit
disturbances (such as irritable bowel syndrome) are common somatic manifestations of
chronic anxiety. The gut-brain axis and the physiological effects of chronic stress often
manifest as gastrointestinal symptoms. A comprehensive assessment should also
include questions about sleep, muscle tension, and other physical symptoms. While
assessing social functioning (option a), occupational performance (option d), and body
image (option b) may be relevant in a broader psychosocial evaluation, they are not the
most specific or common physical manifestations of GAD. The provider should prioritize
exploring somatic symptoms that are frequently associated with anxiety.
DIF: Cognitive Level: Apply (Application) TOP: Mental Health
MSC: NCLEX: Psychosocial Integrity
, The spouse of a patient newly diagnosed with amyotrophic lateral sclerosis (ALS) asks
about long-term care. What will the provider include when teaching the family about
this disease?
a. Bowel and bladder function will eventually be lost
b. Positive-pressure ventilation can prolong life.
c. Preventing malnutrition is a key element in care.
d. The nerves affecting sensation will die initially.
CORRECT ANS: c
Expert Rationale
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that
affects both upper and lower motor neurons, leading to muscle weakness, atrophy, and
spasticity. While the disease eventually affects all voluntary muscles, leading to
respiratory failure and death, it spares cognitive function and sensory nerves. A critical
aspect of care in ALS is preventing malnutrition. As the disease progresses, patients
develop dysphagia and difficulty swallowing, which can lead to inadequate caloric
intake, weight loss, and malnutrition. Malnutrition contributes to muscle wasting,
weakness, and decreased immune function. Therefore, early nutritional assessment and
intervention, including the use of thickened liquids, high-calorie supplements, and
eventually enteral feeding (e.g., percutaneous endoscopic gastrostomy tube), are
essential. Option a is incorrect; bowel and bladder function are typically preserved in
ALS. Option b is partially true but is not the most important element of long-term care;
positive-pressure ventilation (non-invasive ventilation or tracheostomy) can prolong life,
but it is a later intervention. Option d is incorrect; ALS primarily affects motor nerves, not
sensory nerves, so sensation is generally intact.
DIF: Cognitive Level: Understand (Comprehension) TOP: Neurological Disorders
MSC: NCLEX: Physiological Integrity
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?
a. Acupuncture
b. Lubricating eye drops
