NP EXAM 1 REVIEW QUESTIONS AND ANSWERS
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? - CORRECT 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? -
CORRECT 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? - CORRECT 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? - CORRECT
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? - CORRECT
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? - CORRECT 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? - CORRECT 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? -
CORRECT 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? -
CORRECT 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? - CORRECT ANSWER✅✅Cullen's
sign
Patients with polycystic ovarian syndrome (PCOS) may develop all of the following except: - CORRECT
ANSWER✅✅Breast CA
Upon a digital rectal examination, the nurse practitioner notes a warm and boggy prostate. This finding
is consistent with which diagnosis? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER✅✅Glomerular
Filtration Rate
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? - CORRECT 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? -
CORRECT 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? - CORRECT 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? - CORRECT
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? - CORRECT
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? - CORRECT 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? - CORRECT 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? -
CORRECT 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? -
CORRECT 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? - CORRECT ANSWER✅✅Cullen's
sign
Patients with polycystic ovarian syndrome (PCOS) may develop all of the following except: - CORRECT
ANSWER✅✅Breast CA
Upon a digital rectal examination, the nurse practitioner notes a warm and boggy prostate. This finding
is consistent with which diagnosis? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER✅✅Glomerular
Filtration Rate
