FNP Final Exam with Complete Solutions
A patient has recurrent cluster headaches and asks about abortive therapy. Which
therapy is effective for a majority of patients with cluster headaches?
a. Lithium
b. NSAIDs
c. Oxygen
d. Verapamil - ANSWER-C. Oxygen
A patient reports recurrent headaches occurring 1 or 2 times per month that generally
occur with weather changes or when sleep patterns are disrupted and describes them
as severe, with throbbing on one side of the head and sometimes accompanied by
nausea. What is the recommended treatment for this type of headache?
a. Gabapentin
b. Propranolol
c. Rizatriptan
d. Topiramate - ANSWER-c. Rizatriptan
Which medication is NOT useful in treating tension-type headaches?
a. Antiemetics
b. Lithium
c. Muscle relaxants
d. NSAIDse. Oxygen - ANSWER-b. Lithium
A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2
days each about 2 months apart. Which diagnostic testing will the provider order
initially?
a. Lumbar puncture
b. Magnetic resonance imaging
c. Optical Coherence Tomography
d. Visual evoked potential - ANSWER-b. Magnetic resonance imaging
A patient with Parkinson's disease (PD) has been taking carbidopa-levodopa (Sinemet)
with good results but develops increased dyskinesia. Which drug will be added to this
patient's regimen to help control this symptom?
a. Amantadine
b. Benztropine
c. Ropinirole
d. Tolcapone - ANSWER-a. Amantadine
All of the following are common symptoms seen in patients with Parkinson's disease
except:
,a. Bradykinesia
b. Festination
c. Hyperphonia
d. Rigidity
e. Symmetric tremor - ANSWER-c. Hyperphonia
Which drug is used to treat patients with focal epilepsy and complex partial seizures?
a. Carbamazepine
b. Ethosuximide
c. Lamotrigine
d. Topiramate - ANSWER-a. Carbamazepine
A patient develops a gait disorder and the patient's spouse reports noticing recent
personality changes. The provider suspects a brain lesion. Which evaluation is
especially important in the initial physical examination?
a. Assessment of peripheral reflexes
b. Evaluation of speech
c. Examination of the optic fundi
d. Testing for memory loss - ANSWER-c. Examination of the optic fundi
A toddler has begun hitting and biting other children at a day care center and is
exhibiting temper tantrums and bad language at home. The parent reports that these
behaviors began shortly after a sibling was born. What will the primary care pediatric
nurse practitioner do?
A. Advise the parent that the child is exhibiting early symptoms of ADHD.
B. Engage the parent in positive parenting strategies to facilitate appropriate child
coping.
C. Recommend evaluating the child for conduct or oppositional defiant disorder.
D. Suggest putting the child in another day care center to ameliorate the problems -
ANSWER-B. Engage the parent in positive parenting strategies to facilitate appropriate
child coping.
A 14yearold female comes to the clinic with amenorrhea for 3 months. A pregnancy test
is negative. The adolescent's body weight is at 82% of expected for height and age. The
mother reports that her daughter often throws up and refuses to eat most foods. Which
condition does the primary care pediatric nurse practitioner suspect?
A. Anorexia nervosa
B. Bulimia nervosa
C. Depression
D. Substance abuse - ANSWER-A. Anorexia nervosa
During a well child examination on a 4monthold infant, the primary care pediatric nurse
practitioner evaluates mental health issues. Which statement by the parent indicates a
potential problem with the parent infant relationship?
a. "I can sense a difference in my baby's cries."
, b. "I let my baby cry a while to learn to be patient."
c. "My baby prefers to nurse in a darkened room."
d. "My baby seems very sensitive to loud noises." - ANSWER-b. "I let my baby cry a
while to learn to be patient."
The primary care pediatric nurse practitioner attempts to learn more about the emotional
health of an 18monthold child through which assessment strategy?
a. Asking the child to tell a story using dolls and other props
b. Asking the child to draw a picture of him or herself and other family members
c. Interviewing the child separately from caretakers and parents
d. Observation of the child with caretakers in structured and unstructured situations -
ANSWER-d. Observation of the child with caretakers in structured and unstructured
situations
The parent of a 4 year old child reports that the child seems to be having trouble
adjusting to a new day care and reportedly is always engaging in solitary play when the
parent arrives to pick up the child. What will the primary care pediatric nurse practitioner
do?
a. Ask the parent if the child is slow to warm up to other new situations.
b. Reassure the parent that parallel play is common among preschool age children.
c. Recommend that the parent spend time encouraging the child to play with others.
d. Suggest that the day care center may be neglecting the child. - ANSWER-a. Ask the
parent if the child is slow to warm up to other new situations.
The parent of a school age child reports that the child becomes frustrated when unable
to perform tasks well and often has temper tantrums and difficulty sleeping. Which
disorder may be considered in this child?
a. Generalized anxiety disorder (GAD)
b. obsessive-compulsive disorder (OCD)
c. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal
infection (PANDAS)
d. Separation anxiety disorder (SAD) - ANSWER-a. Generalized anxiety disorder (GAD)
A newly divorced mother of a toddler reports that the child began having difficulty
sleeping and nightmares along with exhibiting angry outbursts and tantrums 2 months
prior. The primary care pediatric nurse practitioner learns that the child refuses to play
with usual playmates and often spends time sitting quietly. What will the nurse
practitioner do initially?
a. Ask the mother about the child's relationship with the father.
b. Consult with a child psychiatrist to prescribe medications.
c. Recommend cognitive behavioral or psychodynamic therapy.
A patient has recurrent cluster headaches and asks about abortive therapy. Which
therapy is effective for a majority of patients with cluster headaches?
a. Lithium
b. NSAIDs
c. Oxygen
d. Verapamil - ANSWER-C. Oxygen
A patient reports recurrent headaches occurring 1 or 2 times per month that generally
occur with weather changes or when sleep patterns are disrupted and describes them
as severe, with throbbing on one side of the head and sometimes accompanied by
nausea. What is the recommended treatment for this type of headache?
a. Gabapentin
b. Propranolol
c. Rizatriptan
d. Topiramate - ANSWER-c. Rizatriptan
Which medication is NOT useful in treating tension-type headaches?
a. Antiemetics
b. Lithium
c. Muscle relaxants
d. NSAIDse. Oxygen - ANSWER-b. Lithium
A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2
days each about 2 months apart. Which diagnostic testing will the provider order
initially?
a. Lumbar puncture
b. Magnetic resonance imaging
c. Optical Coherence Tomography
d. Visual evoked potential - ANSWER-b. Magnetic resonance imaging
A patient with Parkinson's disease (PD) has been taking carbidopa-levodopa (Sinemet)
with good results but develops increased dyskinesia. Which drug will be added to this
patient's regimen to help control this symptom?
a. Amantadine
b. Benztropine
c. Ropinirole
d. Tolcapone - ANSWER-a. Amantadine
All of the following are common symptoms seen in patients with Parkinson's disease
except:
,a. Bradykinesia
b. Festination
c. Hyperphonia
d. Rigidity
e. Symmetric tremor - ANSWER-c. Hyperphonia
Which drug is used to treat patients with focal epilepsy and complex partial seizures?
a. Carbamazepine
b. Ethosuximide
c. Lamotrigine
d. Topiramate - ANSWER-a. Carbamazepine
A patient develops a gait disorder and the patient's spouse reports noticing recent
personality changes. The provider suspects a brain lesion. Which evaluation is
especially important in the initial physical examination?
a. Assessment of peripheral reflexes
b. Evaluation of speech
c. Examination of the optic fundi
d. Testing for memory loss - ANSWER-c. Examination of the optic fundi
A toddler has begun hitting and biting other children at a day care center and is
exhibiting temper tantrums and bad language at home. The parent reports that these
behaviors began shortly after a sibling was born. What will the primary care pediatric
nurse practitioner do?
A. Advise the parent that the child is exhibiting early symptoms of ADHD.
B. Engage the parent in positive parenting strategies to facilitate appropriate child
coping.
C. Recommend evaluating the child for conduct or oppositional defiant disorder.
D. Suggest putting the child in another day care center to ameliorate the problems -
ANSWER-B. Engage the parent in positive parenting strategies to facilitate appropriate
child coping.
A 14yearold female comes to the clinic with amenorrhea for 3 months. A pregnancy test
is negative. The adolescent's body weight is at 82% of expected for height and age. The
mother reports that her daughter often throws up and refuses to eat most foods. Which
condition does the primary care pediatric nurse practitioner suspect?
A. Anorexia nervosa
B. Bulimia nervosa
C. Depression
D. Substance abuse - ANSWER-A. Anorexia nervosa
During a well child examination on a 4monthold infant, the primary care pediatric nurse
practitioner evaluates mental health issues. Which statement by the parent indicates a
potential problem with the parent infant relationship?
a. "I can sense a difference in my baby's cries."
, b. "I let my baby cry a while to learn to be patient."
c. "My baby prefers to nurse in a darkened room."
d. "My baby seems very sensitive to loud noises." - ANSWER-b. "I let my baby cry a
while to learn to be patient."
The primary care pediatric nurse practitioner attempts to learn more about the emotional
health of an 18monthold child through which assessment strategy?
a. Asking the child to tell a story using dolls and other props
b. Asking the child to draw a picture of him or herself and other family members
c. Interviewing the child separately from caretakers and parents
d. Observation of the child with caretakers in structured and unstructured situations -
ANSWER-d. Observation of the child with caretakers in structured and unstructured
situations
The parent of a 4 year old child reports that the child seems to be having trouble
adjusting to a new day care and reportedly is always engaging in solitary play when the
parent arrives to pick up the child. What will the primary care pediatric nurse practitioner
do?
a. Ask the parent if the child is slow to warm up to other new situations.
b. Reassure the parent that parallel play is common among preschool age children.
c. Recommend that the parent spend time encouraging the child to play with others.
d. Suggest that the day care center may be neglecting the child. - ANSWER-a. Ask the
parent if the child is slow to warm up to other new situations.
The parent of a school age child reports that the child becomes frustrated when unable
to perform tasks well and often has temper tantrums and difficulty sleeping. Which
disorder may be considered in this child?
a. Generalized anxiety disorder (GAD)
b. obsessive-compulsive disorder (OCD)
c. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal
infection (PANDAS)
d. Separation anxiety disorder (SAD) - ANSWER-a. Generalized anxiety disorder (GAD)
A newly divorced mother of a toddler reports that the child began having difficulty
sleeping and nightmares along with exhibiting angry outbursts and tantrums 2 months
prior. The primary care pediatric nurse practitioner learns that the child refuses to play
with usual playmates and often spends time sitting quietly. What will the nurse
practitioner do initially?
a. Ask the mother about the child's relationship with the father.
b. Consult with a child psychiatrist to prescribe medications.
c. Recommend cognitive behavioral or psychodynamic therapy.
