FNP 652 FINAL EXAM PRACTICE QUESTIONS FROM BUTTARO AND BURNS BOOKS COMPLETE QUESTIONS AND ANSWERS LATEST 2024 UPDATE.

FNP 652 FINAL EXAM PRACTICE QUESTIONS FROM BUTTARO AND BURNS BOOKS COMPLETE QUESTIONS AND ANSWERS LATEST 2024 UPDATE. 1. A patient who has chronic lower back pain reports increased difficulty sleeping unrelated to discomfort, along with a desire to quit working. What will the provider do? A. Ask the patient about addiction issues. B. Consult with a social worker. C. Increase the dosage of prescribed pain medications. D. Order radiographic studies of the lower spine. (ANS: B) Patients who exhibit poor sleep and poor coping may be developing mental defeat as a result of chronic pain and should be evaluated and treated early for this to prevent further disability and improve functionality. Substance abuse may be a part of mental defeat and should be evaluated based on assessment findings. Unless the symptoms are related to pain, increasing the dose of analgesics and ordering diagnostic studies are not indicated. 2. A patient with chronic leg pain describes the pain as “stabbing” and “throbbing.” This is characteristic of which type of pain? A. Neuropathic pain B. Referred pain C. Somatic pain D. Visceral pain (ANS: C) Somatic pain is caused by the activation of nociceptors in the peripheral tissues, including skin, bones, muscles, and soft tissue and is usually well-localized and characterized as stabbing, aching, or throbbing. Neuropathic pain occurs from injury to or disease of the nervous system and is described as burning, shooting, or tingling. Referred pain is a kind of visceral pain that is localized, but not attributable to the involved organ. Visceral pain is related to an organ and is often referred and poorly localized. 3. A patient is beginning treatment for chronic pain and is unable to tolerate nonsteroidal anti- inflammatory drugs. What will the provider prescribe for this patient? A. A mixed opiate product B. A pure opioid compound C. A referral for a nerve block procedure D. A selective serotonin reuptake inhibitor (SSRI) (ANS: D) Using the three-step analgesic ladder, the provider should use step 1 medications that include NSAIDs, tricyclic antidepressants, selective serotonin reuptake inhibitors, or anti- convulsants. Since the patient cannot tolerate NSAIDs, an SSRI is an appropriate choice. The next step if these fail is a mixed opioid product. The third step is a pure opioid product. If medication therapy fails, a referral for nerve block may be necessary. Chapter 17: Obesity and Weight Management 4. A woman who is obese has a neck circumference of 16.5 cm. Which test is necessary to assess for complications of obesity in this patient based on this finding? A. Electrocardiography B. Gallbladder ultrasonography C. Mammography D. Polysomnography (ANS: D) Women with a neck circumference greater than 16 cm have an increased risk of obstructive sleep apnea and should have polysomnography to assess for this complication. The other tests may be necessary for obese patients but are not specific to this finding. 5. Which medications are associated with weight gain? (Select all that apply.) A. Antibiotics B. Antidepressants C. Antihistamines D. Insulin analogs E. Anticonvulsants (ANS: B, C, D, E) Antidepressants, antihistamines, insulin and insulin analogs, and seizure medications are all associated with weight gain. Antibiotics are not associated with weight gain. 6. A provider performs an eye examination during a health maintenance visit and notes a difference of 0.5 mm in size between the patient’s pupils. What does this finding indicate? A. A relative afferent pupillary defect B. Indication of a difference in intraocular pressure C. Likely underlying neurological abnormality D. Probable benign, physiologic anisocoria (ANS: D) A difference in diameter of less than 1 mm is usually benign. Afferent pupillary defects are paradoxical dilations of pupils in response to light. This does not indicate differences in intraocular pressure. A difference of more than 1 mm is more likely to represent an underlying neurological abnormality. 2 7. A patient comes to clinic with diffuse erythema in one eye without pain or history of trauma. The examination reveals a deep red, confluent hemorrhage in the conjunctiva of that eye. What is the most likely treatment for this condition? A. Order lubricating drops or ointments. B. Prescribe ophthalmic antibiotic drops. C. Reassure the patient that this will resolve. D. Refer to an ophthalmologist. (ANS: C) Most subconjunctival hemorrhage, occurring with trauma or Valsalva maneuvers, will self-resolve and are benign. Lubricating drops are used for chemosis. Antibiotic eye drops are not indicated. Referral is not indicated. 8. During an eye examination, the provider notes a red-light reflex in one eye but not the other. What is the significance of this finding? A. Normal physiologic variant B. Ocular disease requiring referral C. Potential infection in the “red” eye D. Potential vision loss in one eye (ANS: B) The red reflex should be elicited in normal eyes. Any asymmetry or opacity suggests ocular disease, potentially retinoblastoma, and should be evaluated immediately. 9. A primary care provider may suspect cataract formation in a patient with which finding? A. Asymmetric red reflex B. Corneal opacification C. Excessive tearing D. Injection of conjunctiva (ANS: A) An asymmetric red reflex may be a finding in a patient with cataracts. Corneal opacification, excessive tearing, and corneal injection are not symptoms of cataracts. 10. Which are risk factors for development of cataracts? (Select all that apply.) A. Advancing age B. Cholesterol C. Conjunctivitis D. Smoking E. Ultraviolet light (ANS: A, D, E) Most older adults will develop cataracts. Smoking and UV light exposure hasten the development of cataracts. Cholesterol and conjunctivitis are not risk factors.