D115 OA pre-Exam Questions With
Complete Solutions
/. An advanced practice registered nurse (APRN) is consulting with a teen patient who
has recently learned that she is pregnant. The APRN knows that a certain medication
taken by the patient can contribute to the development of congenital malformations in
the fetus. The APRN reviews the patient's current medication list and finds one
medication that is a concern.
Which medication is the APRN concerned about? - Answer-Retinoic acid
/.A newborn's screening for cystic fibrosis is positive. An advanced practice registered
nurse (APRN) is reviewing screening results and taking a comprehensive genetic
screening of the parents. The APRN asks the parents questions to help determine the
transmission of this disease.
Which question should the APRN ask? - Answer-"Are you both the genetic donor
parents?"
/.A 30-day-old infant presents to the emergency room with decreased oral intake,
decreased urine output, and a fever of 101.8. The infant is admitted for further
evaluation with a workup to include a blood culture, a urine culture, a spinal tap, and a
chest X-ray.
Which issue of innate immunity, as it relates to neonates, is of concern? - Answer-
Relative deficiency of factor B
/.A 12-year-old African American patient presents with unilateral eye swelling and lower
lip swelling. The patient's parent reports that the swelling is spontaneous and resolves
over several days. The patient does not have complaints of fever, hives, or vomiting.
Serum lab results show hyperactivation of three plasma protein systems. The APRN
suspects hereditary angioedema.
What is the cause of the genetic defect suspected in this situation? - Answer-C1
esterase inhibitor
/.The parent of a child diagnosed with Down syndrome expresses concerns about the
child's recurrent respiratory tract infections to an advanced practice registered nurse
(APRN). The infections have occurred regularly since birth.
What should the APRN tell the parent is the underlying cause of this illness? - Answer-
Gastroesophageal reflux disease causes aspiration of thin fluids.
/.A 36-year-old patient is being seen by an advanced practice registered nurse (APRN)
in a primary care clinic for the first time. The patient reports feeling depressed due to a
major life change. Additional symptoms include weight gain, sedentary activity, and
, insomnia. The APRN plans on providing the patient with several exercises to reduce the
physiological effect of stress.
Why is the APRN concerned about relieving this emotional response? - Answer-It
decreases glucose uptake.
/.An 80-year-old patient brings her grandchildren with her to a routine medical
appointment. The patient has moderate chronic obstructive pulmonary disease (COPD)
and is concerned about developing pneumonia because of its increased incidence at
the senior center.
What should the nurse practitioner recommend for this patient? - Answer-Getting an
annual influenza vaccine
/.An advanced practice nurse (APRN) is working with a patient who is choosing to
undergo breast removal due to family history of breast cancer. The patient's genetic
testing revealed an abnormal BRCA1. The patient shares with the APRN that she is
relieved that she will not need to worry about cancer once the breast tissue is removed.
The APRN proceeds to educate the patient about additional risks.
Which other type of cancer is the patient at risk for developing? - Answer-Ovarian
/.A patient presents to the hospital complaining of blurred vision, muscle weaknesses,
impaired gait, and fatigue lasting more than 24 hours. The patient has a history of
smoking and vitamin D deficiency. Extensive diagnostic testing and a comprehensive
neurological assessment reveals a diagnosis of multiple sclerosis.
Which pathological mechanism will support this diagnosis? - Answer-A loss of myelin
sheaths, causing a disruption of nerve conduction
/.A child presents to a clinic with a white pupillary reflex noted in the right eye. The child
is constantly crying and rubbing her eyes. An advanced practice registered nurse
(APRN) performs a complete ophthalmologic examination and orders several diagnostic
tests. Based on the findings, a diagnosis of retinoblastoma is confirmed.
What is the pathological mechanism of this disorder? - Answer-Mutations of a gene on
chromosome 13q14 lead to neoplastic proliferation of cells
/.A patient is seen by an advanced practice registered nurse (APRN) at a primary care
clinic for follow-up to discuss abnormal results of testing for peripheral nervous system
impairment.
Which diagnosis should the APRN suspect? - Answer-Demyelinating polyneuropathy
/.A patient is seen in the clinic after being a restrained passenger in a car accident the
previous week. The patient continues to have intermittent headaches and has noticed
periods of forgetfulness. Assessment findings include a BP of 130/82 mm Hg and an
apical pulse rate of 72 bpm. An advanced practice registered nurse (APRN) is
concerned that the symptoms might stem from a specific process.
Which process should the APRN be concerned about? - Answer-Cerebral concussion
Complete Solutions
/. An advanced practice registered nurse (APRN) is consulting with a teen patient who
has recently learned that she is pregnant. The APRN knows that a certain medication
taken by the patient can contribute to the development of congenital malformations in
the fetus. The APRN reviews the patient's current medication list and finds one
medication that is a concern.
Which medication is the APRN concerned about? - Answer-Retinoic acid
/.A newborn's screening for cystic fibrosis is positive. An advanced practice registered
nurse (APRN) is reviewing screening results and taking a comprehensive genetic
screening of the parents. The APRN asks the parents questions to help determine the
transmission of this disease.
Which question should the APRN ask? - Answer-"Are you both the genetic donor
parents?"
/.A 30-day-old infant presents to the emergency room with decreased oral intake,
decreased urine output, and a fever of 101.8. The infant is admitted for further
evaluation with a workup to include a blood culture, a urine culture, a spinal tap, and a
chest X-ray.
Which issue of innate immunity, as it relates to neonates, is of concern? - Answer-
Relative deficiency of factor B
/.A 12-year-old African American patient presents with unilateral eye swelling and lower
lip swelling. The patient's parent reports that the swelling is spontaneous and resolves
over several days. The patient does not have complaints of fever, hives, or vomiting.
Serum lab results show hyperactivation of three plasma protein systems. The APRN
suspects hereditary angioedema.
What is the cause of the genetic defect suspected in this situation? - Answer-C1
esterase inhibitor
/.The parent of a child diagnosed with Down syndrome expresses concerns about the
child's recurrent respiratory tract infections to an advanced practice registered nurse
(APRN). The infections have occurred regularly since birth.
What should the APRN tell the parent is the underlying cause of this illness? - Answer-
Gastroesophageal reflux disease causes aspiration of thin fluids.
/.A 36-year-old patient is being seen by an advanced practice registered nurse (APRN)
in a primary care clinic for the first time. The patient reports feeling depressed due to a
major life change. Additional symptoms include weight gain, sedentary activity, and
, insomnia. The APRN plans on providing the patient with several exercises to reduce the
physiological effect of stress.
Why is the APRN concerned about relieving this emotional response? - Answer-It
decreases glucose uptake.
/.An 80-year-old patient brings her grandchildren with her to a routine medical
appointment. The patient has moderate chronic obstructive pulmonary disease (COPD)
and is concerned about developing pneumonia because of its increased incidence at
the senior center.
What should the nurse practitioner recommend for this patient? - Answer-Getting an
annual influenza vaccine
/.An advanced practice nurse (APRN) is working with a patient who is choosing to
undergo breast removal due to family history of breast cancer. The patient's genetic
testing revealed an abnormal BRCA1. The patient shares with the APRN that she is
relieved that she will not need to worry about cancer once the breast tissue is removed.
The APRN proceeds to educate the patient about additional risks.
Which other type of cancer is the patient at risk for developing? - Answer-Ovarian
/.A patient presents to the hospital complaining of blurred vision, muscle weaknesses,
impaired gait, and fatigue lasting more than 24 hours. The patient has a history of
smoking and vitamin D deficiency. Extensive diagnostic testing and a comprehensive
neurological assessment reveals a diagnosis of multiple sclerosis.
Which pathological mechanism will support this diagnosis? - Answer-A loss of myelin
sheaths, causing a disruption of nerve conduction
/.A child presents to a clinic with a white pupillary reflex noted in the right eye. The child
is constantly crying and rubbing her eyes. An advanced practice registered nurse
(APRN) performs a complete ophthalmologic examination and orders several diagnostic
tests. Based on the findings, a diagnosis of retinoblastoma is confirmed.
What is the pathological mechanism of this disorder? - Answer-Mutations of a gene on
chromosome 13q14 lead to neoplastic proliferation of cells
/.A patient is seen by an advanced practice registered nurse (APRN) at a primary care
clinic for follow-up to discuss abnormal results of testing for peripheral nervous system
impairment.
Which diagnosis should the APRN suspect? - Answer-Demyelinating polyneuropathy
/.A patient is seen in the clinic after being a restrained passenger in a car accident the
previous week. The patient continues to have intermittent headaches and has noticed
periods of forgetfulness. Assessment findings include a BP of 130/82 mm Hg and an
apical pulse rate of 72 bpm. An advanced practice registered nurse (APRN) is
concerned that the symptoms might stem from a specific process.
Which process should the APRN be concerned about? - Answer-Cerebral concussion
