CEA advanced Nursing Practice
Question with answers
When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans
in with the right side of his head and frequently asks for things to be repeated. His
daughter is very worried that he has dementia or depression because he has also
become increasingly isolated, as well as increasingly irritable as he believes people
are yelling at him out of frustration of not being heard. The daughter is tearful,
anxious, and frustrated. What should the PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter - -Examine
the patient's ear canals
-A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he
had felt a lump on his left testicle. He is concerned he has not had a physical exam
in 10 years. What is the best action by the PMHNP?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology - -Explore the reason for not having had a physical in so long
-In observing the appearance of the patient with depression and a history of
systemic lupus erythematosus, the PMHNP notices a lesion on the neck of the
patient about the size of a pencil eraser, flush with the skin, uniformly colored, with
discrete borders, and consistent texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology - -Watch and wait
-Which of the following best represent the physical exam maneuver known as
Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg up to the chest.
A positive test occurs when pain prohibits elevation of the ipsilateral leg.
The examiner palpates in the right upper abdominal quadrant below the costal
margin while the patient breathes in. The test is positive if the examiner observes
pain during inhalation.
Press and palpate deeply into the abdomen and release quickly observing for pain.
, Ask the patient to bend at the knees while holding onto a rail, observe for a loss of
balance. - -The examiner palpates in the right upper abdominal quadrant below the
costal margin while the patient breathes in. The test is positive if the examiner
observes pain during inhalation.
Acute cholecystitis
-What does the Murphy sign assess for - -Cholecystitis
-A 26-year-old man has been on an antipsychotic. He requires further titration for
control of symptoms. Which of the following tests should be repeated?
EKG
Head CT scan
Liver function test
Urinalysis - -EKG
-Your client Jamie asks you about a mole of her forearm. You refer her to
dermatology. As an APRN, you recognize that cancerous moles can be detected on
exam. Which of the following would not be of concern?
A mole that is not elevated
A mole that is 5 mm in size
All of the above
A dark mole - -All of the above
-Recall the ABCDE acronym. Concerning moles - -asymmetric, have irregular
borders, have color variation, a diameter > 6mm and elevated moles.
-Which of the following would be considered a risk factor for melanoma?
Female gender
A history of melanoma
A mole with symmetrical borders
A dark covered mole approximately 5mm in size - -A history of melanoma
-Gloria is a 68-year-old female with a chronic history of severe anxiety disorder
presents with mild shortness of breath, fine crackles in the right lower lobe with
auscultation and a nonproductive cough. She recently "ran out of pills". Which
medication omission most likely lead to her current presenting symptoms?
Metoprolol
Lorazepam
Metformin
Furosemide - -Furosemide
-A 62-year-old woman formerly employed as a receptionist reports progressive
word-finding difficulty over the past 6 months that caused her so much anxiety she
quit her job. Her daughter has become increasingly impatient waiting for her to
finish her sentences but she has now become depressed due to the relational strain.
She denies any other behavioral problems. Which of the following diagnostic tests
would be most appropriate?
Bilateral carotid Doppler study
Question with answers
When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans
in with the right side of his head and frequently asks for things to be repeated. His
daughter is very worried that he has dementia or depression because he has also
become increasingly isolated, as well as increasingly irritable as he believes people
are yelling at him out of frustration of not being heard. The daughter is tearful,
anxious, and frustrated. What should the PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter - -Examine
the patient's ear canals
-A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he
had felt a lump on his left testicle. He is concerned he has not had a physical exam
in 10 years. What is the best action by the PMHNP?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology - -Explore the reason for not having had a physical in so long
-In observing the appearance of the patient with depression and a history of
systemic lupus erythematosus, the PMHNP notices a lesion on the neck of the
patient about the size of a pencil eraser, flush with the skin, uniformly colored, with
discrete borders, and consistent texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology - -Watch and wait
-Which of the following best represent the physical exam maneuver known as
Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg up to the chest.
A positive test occurs when pain prohibits elevation of the ipsilateral leg.
The examiner palpates in the right upper abdominal quadrant below the costal
margin while the patient breathes in. The test is positive if the examiner observes
pain during inhalation.
Press and palpate deeply into the abdomen and release quickly observing for pain.
, Ask the patient to bend at the knees while holding onto a rail, observe for a loss of
balance. - -The examiner palpates in the right upper abdominal quadrant below the
costal margin while the patient breathes in. The test is positive if the examiner
observes pain during inhalation.
Acute cholecystitis
-What does the Murphy sign assess for - -Cholecystitis
-A 26-year-old man has been on an antipsychotic. He requires further titration for
control of symptoms. Which of the following tests should be repeated?
EKG
Head CT scan
Liver function test
Urinalysis - -EKG
-Your client Jamie asks you about a mole of her forearm. You refer her to
dermatology. As an APRN, you recognize that cancerous moles can be detected on
exam. Which of the following would not be of concern?
A mole that is not elevated
A mole that is 5 mm in size
All of the above
A dark mole - -All of the above
-Recall the ABCDE acronym. Concerning moles - -asymmetric, have irregular
borders, have color variation, a diameter > 6mm and elevated moles.
-Which of the following would be considered a risk factor for melanoma?
Female gender
A history of melanoma
A mole with symmetrical borders
A dark covered mole approximately 5mm in size - -A history of melanoma
-Gloria is a 68-year-old female with a chronic history of severe anxiety disorder
presents with mild shortness of breath, fine crackles in the right lower lobe with
auscultation and a nonproductive cough. She recently "ran out of pills". Which
medication omission most likely lead to her current presenting symptoms?
Metoprolol
Lorazepam
Metformin
Furosemide - -Furosemide
-A 62-year-old woman formerly employed as a receptionist reports progressive
word-finding difficulty over the past 6 months that caused her so much anxiety she
quit her job. Her daughter has become increasingly impatient waiting for her to
finish her sentences but she has now become depressed due to the relational strain.
She denies any other behavioral problems. Which of the following diagnostic tests
would be most appropriate?
Bilateral carotid Doppler study
