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1. A minor presents by herself to the office requesting to be seen. For which of the following scenarios would
parental consent be necessary to treat the patient?
The patient has a positive urine pregnancy test, but does not want you to tell her parents
The patient is complaining of extremely painful period cramps and moderate bleeding
The patient is sexually active and would like to be started on a birth control pill
The patient has recently enlisted in the military and needs a complete physical exam.
Minors do not need parental consent for care regarding pregnancy, contraception, or sexually transmitted infections.
Additionally, minors who are active duty military or legally married are considered emancipated minors and would therefore
not need any parental consent.
2. If a patient who is eligible for Medicare opts into Part B coverage, which of the following is not covered within this
program?
A patient who needs new glasses due to onset of presbyopia
A patient who needs a second opinion on a recent breast cancer diagnosis
A patient who needs a wheelchair due to recently diagnosed adult onset muscular dystrophy
A patient who needs an emergent ambulance ride to the closest emergency department due to onset of a myocardial
infarction
The Medicare Part B program covers emergent ambulance services, durable medical equipment, second opinions,
outpatient visits, and certain health prevention measures. The Medicare Part C program would cover additional coverages
for hearing, vision, etc.
3. After the death of her mother, a young adolescent begins fulfilling previous duties held by her mother including
cooking meals and ensuring her sisters complete their school work. This is an example of which of the following?
Health belief model
Lewin's change model
Transition care model
Family systems theory
,The family systems theory revolves around the fact that a family acts as a cohesive unit. Therefore, when one member
falters, another member will step in their place to fulfill that role. This theory is based in the belief that the family works
together as an emotional unit with complex interactions.
4. The nurse practitioner is caring for a patient who has a terminal cancer diagnosis. The patient has expressed
interest in stopping all treatment and moving to hospice care instead. The family pulls the provider aside and states
that they would like his treatment to continue instead. The nurse practitioner understands that this would violate
which ethical principle?
Veracity
Autonomy
Paternalism
Nonmaleficence
Autonomy is the ability of the patient to make their own decisions. There is no indication that this patient is incompetent and
therefore the patient has the right to decide what type of care he receives. Paternalism is what occurs when the family or a
healthcare provider actually overrules a patient’s wishes and violates their autonomy. Veracity is about truth telling.
Nonmaleficence is about avoiding harm to patients.
5. A 1C year old presents to their primary care provider for a sports physical. Based on the most common cause of
death in this age group, which of the following is most imperative to educate the patient about during this visit?
Maintaining a healthy diet and active lifestyle will help prevent you from developing cardiovascular disease as you get
older
It is important to wear your seat belt every time you are in the car and make sure you are not distracted while driving
Any firearms in the home should be locked up and out of reach
It is important to stay away from any alcohol or recreational drug use
In teenagers specifically, motor vehicle accidents are the leading cause of death. Teenagers and their families should be
reminded to always wear their seatbelts, never use their phone while driving, and never get in the car with anyone who has
been drinking or using drugs. Keeping firearms out of the home or locked up, not partaking in drug and alcohol luse, and
maintaining a healthy lifestyle are all good teaching points, but are not related to the most common cause of death in
teenagers.
C. The nurse practitioner presents the patient with a cancer diagnosis and spends 30 minutes total discussing
treatment; 25 minutes allocated to palliative care and 5 minutes allocated to chemotherapy. Which ethical principle
is this an example of?
Paternalism
Beneficience
Non-maleficience
Justice
,Paternalism is when the provider makes decisions for the patient without their consent. It can also refer to providers
inappropriately persuading patients to make the decision they prefer, such as by presenting a treatment option in a way that
makes it clearly preferable so it is chosen by the patient. Beneficence is providing the best quality care for patients by
acting in a way that contributes positively to their health and well-being. Non-maleficence means to do no harm by avoiding
or minimizing risk. Justice means that all decisions and treatments for all patients are fair and equal.
7. A new nurse practitioner is applying to be able to bill Medicare for her services. She understands that:
Medicare is funded all at the federal level and gives care to the elderly and people with certain disabilities
Medicare is funded all at the state level and gives care to the elderly and people with certain disabilities
Medicare is funded at both the state and federal level and gives coverage to the elderly and people with certain
disabilities
Medicare is funded at both the state and federal level and give coverage to the low-income population
Medicare is funded federally and provides coverage to those who are older than G5 and those who have certain disabilities
such as end stage renal disease. Medicaid is funded at both the state and federal levels and provides care to people with
low-incomes.
8. Which of the following is not true regarding insurance reimbursement for nurse practitioners?
Nurse practitioners are required to have a National Provider Identifier (NPI) number to bill both medicare and medicaid.
The Balanced Budget Act determined that nurse practitioners will get reimbursed at 85% of what a physician gets
reimbursed for
It is appropriate to use Incident to Billing when the nurse practitioner is seeing the physician’s patients while he is out of
office as long as the physician has already seen that patient for that issue.
The Budget Reconciliation Act was the first piece of legislation passed that allowed nurse practitioners to get paid by
medicare
Both billing at higher and lower levels of services can be considered fraud.
Incident to Billing, where nurse practitioners can bill under the physician’s name to receive 100% reimbursement instead of
85%, can only be used when the NP is seeing the patient for the same thing the physician has already seen them for AND if
the physician is currently in the building and immediately available. It is not appropriate to use this while the physician is out
of office. The Budget Reconciliation Act was the first law that allowed NPs to get paid by medicare. The balanced budget
act required that all NPs get an NPI number in order to bill medicare and medicaid and determined that NPs could bill at
85% of what the physician charges. Under-billing and overbilling our patients can both be considered fraudulent
9. Which of the following cultures believe that the “evil eye” is responsible for illness?
Chinese
Native Americans
Latin Americans
Muslims
, In Latin Americans culture, it is the “evil eye” or Mal de Ojo that is responsible for illness. They believe that young children
and babies are especially vulnerable to this.
10. A patient is participating in a clinical trial. Within this trial, half of the patients receive the true drug and half of
the patients receive a placebo. The patients are not aware of which group they are participating in while completing
the study. Which level of evidence does this situation present?
Meta-analysis
Randomized controlled trial
Cross-sectional study
Cohort study
Randomized controlled trials randomly assign the study participants into either a control group or an experimental group.
The control group receives a placebo to ensure the efficacy of the treatment in those within the experimental group.
11. The nurse practitioner suspects a patient has enterobiasis. Which of the following findings is likely indicative of
this diagnosis?
Lesions in the webs of their fingers and groin that are very itchy at night
Abdominal cramping and diarrhea present after drinking river water during a recent camping trip
Perianal itching when they go to bed and throughout the night
An erythematous, bleeding cervix with purulent vaginal discharge
Enterobiasis, also known as pinworms, causes anal itching that is most severe at night. Patients often experience insomnia
and restlessness. To diagnose enterobiasis, the scotch tape test is performed first thing in the morning.
12. Which of the following murmurs would be the most likely for the nurse practitioner to be able to palpate a thrill?
Mitral regurgitation
Aortic stenosis
Mitral valve prolapse
Mitral stenosis
Systolic murmurs are considered benign in nature, and therefore do not typically become loud enough to produce a thrill.
Mitral regurgitation, aortic stenosis, and mitral valve prolapse are all systolic murmurs while mitral stenosis is a diastolic
murmur.
13. The nurse practitioner suspects a middle aged patient may have peripheral arterial disease and decides to order
an ankle brachial index (ABI). The highest systolic pressure in the right foot was 143, and the highest systolic
pressure in both arms was 1C1. Which of the following is the correct calculation and interpretation of these results?
The ABI is 0.88, which is indicative of peripheral arterial disease
The ABI is 0.88, which is not indicative of peripheral arterial disease
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Congrats on finishing the quiz!
Congratulations you scored 71 % on the quiz
1. A minor presents by herself to the office requesting to be seen. For which of the following scenarios would
parental consent be necessary to treat the patient?
The patient has a positive urine pregnancy test, but does not want you to tell her parents
The patient is complaining of extremely painful period cramps and moderate bleeding
The patient is sexually active and would like to be started on a birth control pill
The patient has recently enlisted in the military and needs a complete physical exam.
Minors do not need parental consent for care regarding pregnancy, contraception, or sexually transmitted infections.
Additionally, minors who are active duty military or legally married are considered emancipated minors and would therefore
not need any parental consent.
2. If a patient who is eligible for Medicare opts into Part B coverage, which of the following is not covered within this
program?
A patient who needs new glasses due to onset of presbyopia
A patient who needs a second opinion on a recent breast cancer diagnosis
A patient who needs a wheelchair due to recently diagnosed adult onset muscular dystrophy
A patient who needs an emergent ambulance ride to the closest emergency department due to onset of a myocardial
infarction
The Medicare Part B program covers emergent ambulance services, durable medical equipment, second opinions,
outpatient visits, and certain health prevention measures. The Medicare Part C program would cover additional coverages
for hearing, vision, etc.
3. After the death of her mother, a young adolescent begins fulfilling previous duties held by her mother including
cooking meals and ensuring her sisters complete their school work. This is an example of which of the following?
Health belief model
Lewin's change model
Transition care model
Family systems theory
,The family systems theory revolves around the fact that a family acts as a cohesive unit. Therefore, when one member
falters, another member will step in their place to fulfill that role. This theory is based in the belief that the family works
together as an emotional unit with complex interactions.
4. The nurse practitioner is caring for a patient who has a terminal cancer diagnosis. The patient has expressed
interest in stopping all treatment and moving to hospice care instead. The family pulls the provider aside and states
that they would like his treatment to continue instead. The nurse practitioner understands that this would violate
which ethical principle?
Veracity
Autonomy
Paternalism
Nonmaleficence
Autonomy is the ability of the patient to make their own decisions. There is no indication that this patient is incompetent and
therefore the patient has the right to decide what type of care he receives. Paternalism is what occurs when the family or a
healthcare provider actually overrules a patient’s wishes and violates their autonomy. Veracity is about truth telling.
Nonmaleficence is about avoiding harm to patients.
5. A 1C year old presents to their primary care provider for a sports physical. Based on the most common cause of
death in this age group, which of the following is most imperative to educate the patient about during this visit?
Maintaining a healthy diet and active lifestyle will help prevent you from developing cardiovascular disease as you get
older
It is important to wear your seat belt every time you are in the car and make sure you are not distracted while driving
Any firearms in the home should be locked up and out of reach
It is important to stay away from any alcohol or recreational drug use
In teenagers specifically, motor vehicle accidents are the leading cause of death. Teenagers and their families should be
reminded to always wear their seatbelts, never use their phone while driving, and never get in the car with anyone who has
been drinking or using drugs. Keeping firearms out of the home or locked up, not partaking in drug and alcohol luse, and
maintaining a healthy lifestyle are all good teaching points, but are not related to the most common cause of death in
teenagers.
C. The nurse practitioner presents the patient with a cancer diagnosis and spends 30 minutes total discussing
treatment; 25 minutes allocated to palliative care and 5 minutes allocated to chemotherapy. Which ethical principle
is this an example of?
Paternalism
Beneficience
Non-maleficience
Justice
,Paternalism is when the provider makes decisions for the patient without their consent. It can also refer to providers
inappropriately persuading patients to make the decision they prefer, such as by presenting a treatment option in a way that
makes it clearly preferable so it is chosen by the patient. Beneficence is providing the best quality care for patients by
acting in a way that contributes positively to their health and well-being. Non-maleficence means to do no harm by avoiding
or minimizing risk. Justice means that all decisions and treatments for all patients are fair and equal.
7. A new nurse practitioner is applying to be able to bill Medicare for her services. She understands that:
Medicare is funded all at the federal level and gives care to the elderly and people with certain disabilities
Medicare is funded all at the state level and gives care to the elderly and people with certain disabilities
Medicare is funded at both the state and federal level and gives coverage to the elderly and people with certain
disabilities
Medicare is funded at both the state and federal level and give coverage to the low-income population
Medicare is funded federally and provides coverage to those who are older than G5 and those who have certain disabilities
such as end stage renal disease. Medicaid is funded at both the state and federal levels and provides care to people with
low-incomes.
8. Which of the following is not true regarding insurance reimbursement for nurse practitioners?
Nurse practitioners are required to have a National Provider Identifier (NPI) number to bill both medicare and medicaid.
The Balanced Budget Act determined that nurse practitioners will get reimbursed at 85% of what a physician gets
reimbursed for
It is appropriate to use Incident to Billing when the nurse practitioner is seeing the physician’s patients while he is out of
office as long as the physician has already seen that patient for that issue.
The Budget Reconciliation Act was the first piece of legislation passed that allowed nurse practitioners to get paid by
medicare
Both billing at higher and lower levels of services can be considered fraud.
Incident to Billing, where nurse practitioners can bill under the physician’s name to receive 100% reimbursement instead of
85%, can only be used when the NP is seeing the patient for the same thing the physician has already seen them for AND if
the physician is currently in the building and immediately available. It is not appropriate to use this while the physician is out
of office. The Budget Reconciliation Act was the first law that allowed NPs to get paid by medicare. The balanced budget
act required that all NPs get an NPI number in order to bill medicare and medicaid and determined that NPs could bill at
85% of what the physician charges. Under-billing and overbilling our patients can both be considered fraudulent
9. Which of the following cultures believe that the “evil eye” is responsible for illness?
Chinese
Native Americans
Latin Americans
Muslims
, In Latin Americans culture, it is the “evil eye” or Mal de Ojo that is responsible for illness. They believe that young children
and babies are especially vulnerable to this.
10. A patient is participating in a clinical trial. Within this trial, half of the patients receive the true drug and half of
the patients receive a placebo. The patients are not aware of which group they are participating in while completing
the study. Which level of evidence does this situation present?
Meta-analysis
Randomized controlled trial
Cross-sectional study
Cohort study
Randomized controlled trials randomly assign the study participants into either a control group or an experimental group.
The control group receives a placebo to ensure the efficacy of the treatment in those within the experimental group.
11. The nurse practitioner suspects a patient has enterobiasis. Which of the following findings is likely indicative of
this diagnosis?
Lesions in the webs of their fingers and groin that are very itchy at night
Abdominal cramping and diarrhea present after drinking river water during a recent camping trip
Perianal itching when they go to bed and throughout the night
An erythematous, bleeding cervix with purulent vaginal discharge
Enterobiasis, also known as pinworms, causes anal itching that is most severe at night. Patients often experience insomnia
and restlessness. To diagnose enterobiasis, the scotch tape test is performed first thing in the morning.
12. Which of the following murmurs would be the most likely for the nurse practitioner to be able to palpate a thrill?
Mitral regurgitation
Aortic stenosis
Mitral valve prolapse
Mitral stenosis
Systolic murmurs are considered benign in nature, and therefore do not typically become loud enough to produce a thrill.
Mitral regurgitation, aortic stenosis, and mitral valve prolapse are all systolic murmurs while mitral stenosis is a diastolic
murmur.
13. The nurse practitioner suspects a middle aged patient may have peripheral arterial disease and decides to order
an ankle brachial index (ABI). The highest systolic pressure in the right foot was 143, and the highest systolic
pressure in both arms was 1C1. Which of the following is the correct calculation and interpretation of these results?
The ABI is 0.88, which is indicative of peripheral arterial disease
The ABI is 0.88, which is not indicative of peripheral arterial disease
