NP Exam 1 Review Questions And
Complete Answers 100% Pass
A 43-year-old male recently underwent three months worth of lifestyle interventions but
only had a moderate change in overall blood pressure readings at home. At today's visit,
his blood pressure is consistent with his home readings, and is 138/85. The nurse
practitioner knows that according to the AHA guidelines, we should begin initiating
medications for a stage 1 hypertensive patient at what ASCVD cutoff point? - answer
10%
it is appropriate to initiate antihypertensives if their ASCVD risk score is 10% or greater.
(Hint: can think of hyperTENsion to remember!)
A middle-aged female presents to your clinic today. She has a history of smoking,
hypertension, type II diabetes, and osteoporosis. She has been on lisinopril (Prinvil) 10
mg daily for the past five years and metformin (Glucophage) 500 mg twice daily. Upon
your physical exam you notice asymmetric, non-pitting swelling around her upper lip
which the patient states started yesterday night and is painless. She also reports diffuse
abdominal pain and diarrhea. The rest of the physical exam was benign. Her fasting
blood glucose is 130. Her vital signs are as follows: BP: 141/87 mmHg, HR: 92 bpm, RR:
12 breaths per minute, O2: 96% on room air. What is the most important thing for the
nurse practitioner to do? - answer Discontinue her lisinopril
This patient is experiencing angioedema - ACE Inhibitor induced angioedema can occur
anytime (days, weeks, or years after initiation). In addition to swelling of the lips, tongue,
and face, visceral angioedema due to an ACE inhibitor can occur and cause symptoms
including abdominal pain, diarrhea, and vomiting. She needs to immediately stop the
lisinopril and it needs to be marked as an allergy.
A patient calls the office complaining of a sudden onset of "cobweb like lines" moving in
and out of her central vision in the right eye. She is not in any pain and is asking if she
needs to come in and be seen. What should the nurse practitioner advise her to do? -
answer Refer to opthalmogogy immediately
A group of new nurse practitioners are evaluating the strength of evidence of some new
asthma guidelines. Which of the following would be at the bottom of the hierarchy of
evidence? - answer Editorial
A 55-year-old male patient reports increasing issues with erectile dysfunction over the
last six months. He is requesting to be placed on tadalafil (Cialis) for control of this
condition. Which of the following is critical for the nurse practitioner to order prior to
prescribing this medication? - answer EKG
,You are performing an annual exam and pap smear on a 39-year-old woman who states
she has never had a mammogram before. A close friend of hers was just diagnosed with
breast cancer and she is wanting to know more about her risk and when she should
begin screening. What in her history would be considered a risk factor for breast
cancer? - answer Her only child is a step daughter
You recently diagnosed your patient with sciatica. You ask the patient to perform the
squat and rise exam, and you found that there is a diminished knee jerk. Which of the
following is the root cause of his sciatica based on this finding? - answer L4
The squat and rise exam with a diminished knee jerk links to the L4 nerve. We can
assess L5 with the heel walk and S1 with the toe walk.
You are assessing a patient for acute abdominal pain. With the patient supine and right
knee flexed, you perform inward rotation on the patient's hip. What maneuver is this and
what are you assessing for? - answer Obturator sign to assess for appendicitis
Obturator- Is inward rOtation of the hip through full ROM and is a pOsitive sign w/
mOvement or flexion of the hip (I think of all the O's). Iliopsoas/psoas sign is performed
by having patients raise their leg against resistance in a supine position, then while on
their left side, extending the right leg from the hip ( When you do leg raises at the gym,
your iliopsoas muscles are sore). Murphy's sign is elicited when deep palpation on the
RUQ under the costal border produces pain during Midinspiratory arrest (I think M for
Murphy's and M for Midinspiratory).
An 85-year-old woman presents to the clinic today for a follow up x-ray. She states that
she had x-rays completed 11 days after a fall at home but the imaging was negative at
that time. Due to the nature of her fall, she was instructed to come in for an additional
set of x-rays if the pain persisted. The nurse practitioner knows that if this patient has a
fracture today, it is most likely which of the following? - answer Scaphoid fracture
Your 63-year-old male patient with vague abdominal pain has a triglyceride level of 899.
Which of the following clinical signs would be most concerning given this lab value? -
answer Cullen's sign
Patients with polycystic ovarian syndrome (PCOS) may develop all of the following
except: - answer Breast CA
Upon a digital rectal examination, the nurse practitioner notes a warm and boggy
prostate. This finding is consistent with which diagnosis? - answer Prostatitis
A 67-year-old male patient is currently being treated for benign prostatic hyperplasia.
He is concerned that his finasteride (Proscar) is not adequately treating his symptoms.
Which of the following questions is most important to ask this patient to do a further
assessment? - answer How long have you been taking this medication?
A 33-year-old female is complaining of dysuria, flank pain and a fever. Her vital signs are
as follows: BP: 112/76, HR: 76, RR: 18, 97% on room air, Temp: 101.6 F. The patient
, states she has had a urinary tract infection off and on over the past month and
antibiotics never really helped. Upon your physical exam you elicit CVA tenderness.
What is the best plan for this patient? - answer Referral to the emergency room
A 14-year-old male is complaining of scrotal pain. Which of the following descriptions
would warrant immediate referral? - answer The pain is unilateral and when you gently
pinch the inner thigh, the testicle does not elevate
An elderly patient who lives with his daughter is diagnosed with terminal cancer and
asks you to not share the information with his daughter. Not sharing this information
without the patient's consent upholds which ethical principle? - answer Fidelity
You are concerned that your diabetic patient may be developing chronic kidney disease.
Which lab would be the best evaluation of the patient's kidney function? - answer
Glomerular Filtration Rate
A 67-year-old female patient comes into the clinic today with a chief complaint of joint
pain and stiffness. Which of the following symptoms would lead you to include
osteoarthritis as a possible differential? - answer Morning stiffness lasting <1 hour
Which of the following is not a possible long-term complication of bulimia? - answer
Higher seizure threshold
As a nurse practitioner, you want to educate your patient about the possible
microvascular complications of diabetes that may occur. Which of the following is not
one of these complications? - answer Stroke
You are concerned about prescribing an antidiabetic medication that may cause
hypoglycemia because your patient has a history of falls. Which of the following
medications would be most appropriate to prescribe? - answer Metformin
A middle-aged patient recently presented to the clinic with twitching of the upper lip and
cheek in addition to new paresthesias noted in their fingertips and toes. The nurse
practitioner would expect which of the following lab levels to be decreased when the
labs result? - answer Calcium
A patient suffering from new palpitations and tremors has recently been diagnosed with
hyperthyroidism. Upon assessment, the following EKG results are interpreted: an
irregular QRS complex and absent P waves. Which of the following would be the most
appropriate interpretation of this EKG? - answer A FIB
Complete Answers 100% Pass
A 43-year-old male recently underwent three months worth of lifestyle interventions but
only had a moderate change in overall blood pressure readings at home. At today's visit,
his blood pressure is consistent with his home readings, and is 138/85. The nurse
practitioner knows that according to the AHA guidelines, we should begin initiating
medications for a stage 1 hypertensive patient at what ASCVD cutoff point? - answer
10%
it is appropriate to initiate antihypertensives if their ASCVD risk score is 10% or greater.
(Hint: can think of hyperTENsion to remember!)
A middle-aged female presents to your clinic today. She has a history of smoking,
hypertension, type II diabetes, and osteoporosis. She has been on lisinopril (Prinvil) 10
mg daily for the past five years and metformin (Glucophage) 500 mg twice daily. Upon
your physical exam you notice asymmetric, non-pitting swelling around her upper lip
which the patient states started yesterday night and is painless. She also reports diffuse
abdominal pain and diarrhea. The rest of the physical exam was benign. Her fasting
blood glucose is 130. Her vital signs are as follows: BP: 141/87 mmHg, HR: 92 bpm, RR:
12 breaths per minute, O2: 96% on room air. What is the most important thing for the
nurse practitioner to do? - answer Discontinue her lisinopril
This patient is experiencing angioedema - ACE Inhibitor induced angioedema can occur
anytime (days, weeks, or years after initiation). In addition to swelling of the lips, tongue,
and face, visceral angioedema due to an ACE inhibitor can occur and cause symptoms
including abdominal pain, diarrhea, and vomiting. She needs to immediately stop the
lisinopril and it needs to be marked as an allergy.
A patient calls the office complaining of a sudden onset of "cobweb like lines" moving in
and out of her central vision in the right eye. She is not in any pain and is asking if she
needs to come in and be seen. What should the nurse practitioner advise her to do? -
answer Refer to opthalmogogy immediately
A group of new nurse practitioners are evaluating the strength of evidence of some new
asthma guidelines. Which of the following would be at the bottom of the hierarchy of
evidence? - answer Editorial
A 55-year-old male patient reports increasing issues with erectile dysfunction over the
last six months. He is requesting to be placed on tadalafil (Cialis) for control of this
condition. Which of the following is critical for the nurse practitioner to order prior to
prescribing this medication? - answer EKG
,You are performing an annual exam and pap smear on a 39-year-old woman who states
she has never had a mammogram before. A close friend of hers was just diagnosed with
breast cancer and she is wanting to know more about her risk and when she should
begin screening. What in her history would be considered a risk factor for breast
cancer? - answer Her only child is a step daughter
You recently diagnosed your patient with sciatica. You ask the patient to perform the
squat and rise exam, and you found that there is a diminished knee jerk. Which of the
following is the root cause of his sciatica based on this finding? - answer L4
The squat and rise exam with a diminished knee jerk links to the L4 nerve. We can
assess L5 with the heel walk and S1 with the toe walk.
You are assessing a patient for acute abdominal pain. With the patient supine and right
knee flexed, you perform inward rotation on the patient's hip. What maneuver is this and
what are you assessing for? - answer Obturator sign to assess for appendicitis
Obturator- Is inward rOtation of the hip through full ROM and is a pOsitive sign w/
mOvement or flexion of the hip (I think of all the O's). Iliopsoas/psoas sign is performed
by having patients raise their leg against resistance in a supine position, then while on
their left side, extending the right leg from the hip ( When you do leg raises at the gym,
your iliopsoas muscles are sore). Murphy's sign is elicited when deep palpation on the
RUQ under the costal border produces pain during Midinspiratory arrest (I think M for
Murphy's and M for Midinspiratory).
An 85-year-old woman presents to the clinic today for a follow up x-ray. She states that
she had x-rays completed 11 days after a fall at home but the imaging was negative at
that time. Due to the nature of her fall, she was instructed to come in for an additional
set of x-rays if the pain persisted. The nurse practitioner knows that if this patient has a
fracture today, it is most likely which of the following? - answer Scaphoid fracture
Your 63-year-old male patient with vague abdominal pain has a triglyceride level of 899.
Which of the following clinical signs would be most concerning given this lab value? -
answer Cullen's sign
Patients with polycystic ovarian syndrome (PCOS) may develop all of the following
except: - answer Breast CA
Upon a digital rectal examination, the nurse practitioner notes a warm and boggy
prostate. This finding is consistent with which diagnosis? - answer Prostatitis
A 67-year-old male patient is currently being treated for benign prostatic hyperplasia.
He is concerned that his finasteride (Proscar) is not adequately treating his symptoms.
Which of the following questions is most important to ask this patient to do a further
assessment? - answer How long have you been taking this medication?
A 33-year-old female is complaining of dysuria, flank pain and a fever. Her vital signs are
as follows: BP: 112/76, HR: 76, RR: 18, 97% on room air, Temp: 101.6 F. The patient
, states she has had a urinary tract infection off and on over the past month and
antibiotics never really helped. Upon your physical exam you elicit CVA tenderness.
What is the best plan for this patient? - answer Referral to the emergency room
A 14-year-old male is complaining of scrotal pain. Which of the following descriptions
would warrant immediate referral? - answer The pain is unilateral and when you gently
pinch the inner thigh, the testicle does not elevate
An elderly patient who lives with his daughter is diagnosed with terminal cancer and
asks you to not share the information with his daughter. Not sharing this information
without the patient's consent upholds which ethical principle? - answer Fidelity
You are concerned that your diabetic patient may be developing chronic kidney disease.
Which lab would be the best evaluation of the patient's kidney function? - answer
Glomerular Filtration Rate
A 67-year-old female patient comes into the clinic today with a chief complaint of joint
pain and stiffness. Which of the following symptoms would lead you to include
osteoarthritis as a possible differential? - answer Morning stiffness lasting <1 hour
Which of the following is not a possible long-term complication of bulimia? - answer
Higher seizure threshold
As a nurse practitioner, you want to educate your patient about the possible
microvascular complications of diabetes that may occur. Which of the following is not
one of these complications? - answer Stroke
You are concerned about prescribing an antidiabetic medication that may cause
hypoglycemia because your patient has a history of falls. Which of the following
medications would be most appropriate to prescribe? - answer Metformin
A middle-aged patient recently presented to the clinic with twitching of the upper lip and
cheek in addition to new paresthesias noted in their fingertips and toes. The nurse
practitioner would expect which of the following lab levels to be decreased when the
labs result? - answer Calcium
A patient suffering from new palpitations and tremors has recently been diagnosed with
hyperthyroidism. Upon assessment, the following EKG results are interpreted: an
irregular QRS complex and absent P waves. Which of the following would be the most
appropriate interpretation of this EKG? - answer A FIB
