FNP 654 FINAL EXAM QUESTIONS
WITH CORRECT MARKING SCHEME
/. A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to have
symptoms that include asymmetric weakness in the arms and difficulty walking. The
neurologist recognizes these symptoms as characteristic of involvement of which
portion of the nervous system? - Answer-✅Lower motor neurons
/.The spouse of a patient newly-diagnosed with amyotrophic lateral sclerosis (ALS) asks
about long-term care. What will the provider include when teaching the family about this
disease? - Answer-✅Preventing malnutrition is a key element in care.
/.Which symptoms may occur with Bell's palsy?
Select all that apply. - Answer-✅Alteration in taste, Drooling, Tinnitus
/.A 35-year-old patient reports suddenly experiencing an asymmetric smile along with
drooping and tearing in one eye. The patient has a history of a recent viral illness, but is
otherwise healthy. During the exam, the provider notes that there is unilateral full face
paralysis on the right side. What is the initial intervention for this patient? - Answer-
✅Prescribe oral prednisolone
/.What is recommended to prevent ophthalmic complications in patients with Bell's
palsy? - Answer-✅Lubricating eye drops
/.A patient reports a recurrent sensation of spinning associated with nausea and
vomiting. Which test will the provider order to confirm a diagnosis for this patient? -
Answer-✅The Hallpike-Dix positioning maneuver
/.An elderly patient reports sensations of being off balance when walking, but does not
experience dizziness. The provider will refer this patient to which specialist for further
evaluation? - Answer-✅Neurologist
/.Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient
who is developing muscle weakness and paresthesias? - Answer-✅Lumbar puncture
/.Which monitoring parameters are necessary when caring for a patient with Guillain-
Barre syndrome?
Select all that apply. - Answer-✅Bladder scans
Cardiac telemetry
Fever
Vital capacity measures
,/.Following an upper respiratory infection, a patient begins to develop ataxia and distal
paresthesias, along with oculomotor symptoms and double vision. Based on these
presenting symptoms which type of GBS does this patient have? - Answer-✅Miller
Fisher syndrome (MFS)
/.A patient has recurrent cluster headaches and asks about abortive therapy. Which
therapy is effective for a majority of patients with cluster headaches? - Answer-
✅Oxygen
/.A patient reports recurrent headaches occurring 1 or 2 times per month that generally
occur with weather changes or when sleep patterns are disrupted and describes them
as severe, with throbbing on one side of the head and sometimes accompanied by
nausea. What is the recommended treatment for this type of headache? - Answer-
✅Rizatriptan
/.Which medications may be useful in treating tension-type headache?
Select all that apply. - Answer-✅Antiemetics
Muscle relaxants
NSAIDs
/.A provider suspects that a patient has bacterial meningitis. When should antibiotics be
given? - Answer-✅Prior to obtaining a CT scan or lumbar puncture
/.A patient is brought to the emergency department with fever, lethargy, and headache
without meningeal signs. The examination reveals hypotension and lethargy and the
examiner notes petechiae on the patient's trunk. What do these findings indicate? -
Answer-✅A poor prognosis
/.A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2
days each about 2 months apart. Which diagnostic testing will the provider order
initially? - Answer-✅Magnetic resonance imaging
/.A patient diagnosed with multiple sclerosis and begins disease modulating therapy
drugs. As part of the counseling about this therapy, the provider will tell the patient that
this regimen will - Answer-✅reduce the exacerbation rate.
/.A patient who has a seizure disorder and who takes levetiracetam is brought to an
emergency department with a seizure which has persisted for15 minutes and which
immediately followed another 15 minute seizure. What is the priority action for this
patient? - Answer-✅Administer lorazepam and monitor cardiorespiratory status
/.A patient with a seizure disorder has seizures which begin with eye twitching and
occasionally visual hallucinations. Which site in the brain is the seizure focus? - Answer-
✅Occipital
,/.Which drug is used to treat patients with focal epilepsy and complex partial seizures? -
Answer-✅Carbamazepine
/.A patient reports paroxysms of burning, shock-like pain on both sides of the face
usually triggered by chewing or talking. The provider suspects trigeminal neuralgia.
Based on these presenting symptoms, what testing is indicated? - Answer-✅Magnetic
resonance imaging
/.A patient with trigeminal neuralgia has tried several medication regimens to control
pain without success. What is the next step in management for this condition? - Answer-
✅Referral to a neurosurgeon
/.A patient is diagnosed with trigeminal neuralgia and reports having paroxysms several
times each day. What is the initial treatment for this patient? - Answer-✅A high dose of
carbamazepine with subsequent titration downward
/.A patient develops a gait disorder and the patient's spouse reports noticing recent
personality changes. The provider suspects a brain lesion. Which evaluation is
especially important in the initial physical examination? - Answer-✅Examination of the
optic fundi
/.Which is the preferred treatment for primary brain tumors? - Answer-✅Surgical
resection
/.A patient is diagnosed with panic disorder and begins taking a selective serotonin
reuptake inhibitor medication. Six weeks later, the patient reports little relief from
symptoms. What will the provider do next to manage this patient? - Answer-✅Refer to a
mental health provider
/.Which medication are useful in treating both obsessive-compulsive disorder and
PTSD?
Select all that apply. - Answer-✅Selective serotonin reuptake inhibitors
Serotonin-norepinephrine reuptake inhibitors
Tricyclic antidepressants
/.A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The
provider determines that these symptoms occur in relation to many events and
concerns. What other things will the provider question this patient about? - Answer-
✅Headaches and bowel habits
/.A patient is seen in clinic 2 weeks after the death of a parent. The patient reports
feelings of sadness and hopelessness and a feeling that the parent is still present, even
to the point of hearing the parent's voice at times. What will the provider determine from
these findings? - Answer-✅These are normal grief responses.
, /.A college student is brought to clinic by a parent who is concerned about increasingly
bizarre behavior and poor school performance. The provider notes difficulty engaging
the patient in an organized conversation. The patient denies any concerns about
behavior. What will the provider do initially to manage this patient's symptoms? -
Answer-✅Begin treatment with lithium or lamotrigine
/.A patient is seen frequently over a 9-month period with somatic complaints that are not
related to physical disease. The primary provider notes that the patient has had a 15%
weight loss in the previous 2 months and the patient reports difficulty sleeping. The
spouse tells the provider that the patient seems tired all the time and is irritable with
other family members. What will the provider do initially? - Answer-✅Perform a suicide
risk assessment
/.A patient is brought to the emergency department who is experiencing disorientation,
confusion, and fever. The patient describes visual and auditory hallucinations. The
patient's spouse states that the patient had several drinks 12 hours prior to passing out.
A blood alcohol level is 0.2%. What is the recommended treatment? - Answer-
✅Benzodiazepines
/.A college student is brought to the emergency department by a roommate who is
concerned about symptoms of extreme restlessness, nausea, and vomiting. The
provider notes elevations of the pulse and blood pressure and pupillary dilation, along
with hyperactive bowel sounds. The provider suspects withdrawal from which
substance? - Answer-✅Opioids
/.A 17-year-old male is brought to the clinic by a parent who is concerned that the
patient has become more isolated and withdrawn and expresses suspicions that his
teachers hate him and want him to fail. What will the provider tell this parent? - Answer-
✅The adolescent should be evaluated by a psychiatrist.
/.A young male patient is reported to be more withdrawn from his peers than usual and
has dropped out of college and quit his job within the last 5 months. The parent is
concerned that the patient may have schizophrenia because a maternal uncle has the
disease. What will the provider do next? - Answer-✅Ask about the patient's speech and
thinking patterns
/.Which are considered "negative" symptoms of schizophrenia?
Select all that apply. - Answer-✅Impaired self care
Poor school performance
Withdrawing from peers
/.When prescribing medications to an 80-year-old patient, the provider will - Answer-
✅consult the Beers list to help identify potentially problematic drugs.
WITH CORRECT MARKING SCHEME
/. A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to have
symptoms that include asymmetric weakness in the arms and difficulty walking. The
neurologist recognizes these symptoms as characteristic of involvement of which
portion of the nervous system? - Answer-✅Lower motor neurons
/.The spouse of a patient newly-diagnosed with amyotrophic lateral sclerosis (ALS) asks
about long-term care. What will the provider include when teaching the family about this
disease? - Answer-✅Preventing malnutrition is a key element in care.
/.Which symptoms may occur with Bell's palsy?
Select all that apply. - Answer-✅Alteration in taste, Drooling, Tinnitus
/.A 35-year-old patient reports suddenly experiencing an asymmetric smile along with
drooping and tearing in one eye. The patient has a history of a recent viral illness, but is
otherwise healthy. During the exam, the provider notes that there is unilateral full face
paralysis on the right side. What is the initial intervention for this patient? - Answer-
✅Prescribe oral prednisolone
/.What is recommended to prevent ophthalmic complications in patients with Bell's
palsy? - Answer-✅Lubricating eye drops
/.A patient reports a recurrent sensation of spinning associated with nausea and
vomiting. Which test will the provider order to confirm a diagnosis for this patient? -
Answer-✅The Hallpike-Dix positioning maneuver
/.An elderly patient reports sensations of being off balance when walking, but does not
experience dizziness. The provider will refer this patient to which specialist for further
evaluation? - Answer-✅Neurologist
/.Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient
who is developing muscle weakness and paresthesias? - Answer-✅Lumbar puncture
/.Which monitoring parameters are necessary when caring for a patient with Guillain-
Barre syndrome?
Select all that apply. - Answer-✅Bladder scans
Cardiac telemetry
Fever
Vital capacity measures
,/.Following an upper respiratory infection, a patient begins to develop ataxia and distal
paresthesias, along with oculomotor symptoms and double vision. Based on these
presenting symptoms which type of GBS does this patient have? - Answer-✅Miller
Fisher syndrome (MFS)
/.A patient has recurrent cluster headaches and asks about abortive therapy. Which
therapy is effective for a majority of patients with cluster headaches? - Answer-
✅Oxygen
/.A patient reports recurrent headaches occurring 1 or 2 times per month that generally
occur with weather changes or when sleep patterns are disrupted and describes them
as severe, with throbbing on one side of the head and sometimes accompanied by
nausea. What is the recommended treatment for this type of headache? - Answer-
✅Rizatriptan
/.Which medications may be useful in treating tension-type headache?
Select all that apply. - Answer-✅Antiemetics
Muscle relaxants
NSAIDs
/.A provider suspects that a patient has bacterial meningitis. When should antibiotics be
given? - Answer-✅Prior to obtaining a CT scan or lumbar puncture
/.A patient is brought to the emergency department with fever, lethargy, and headache
without meningeal signs. The examination reveals hypotension and lethargy and the
examiner notes petechiae on the patient's trunk. What do these findings indicate? -
Answer-✅A poor prognosis
/.A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2
days each about 2 months apart. Which diagnostic testing will the provider order
initially? - Answer-✅Magnetic resonance imaging
/.A patient diagnosed with multiple sclerosis and begins disease modulating therapy
drugs. As part of the counseling about this therapy, the provider will tell the patient that
this regimen will - Answer-✅reduce the exacerbation rate.
/.A patient who has a seizure disorder and who takes levetiracetam is brought to an
emergency department with a seizure which has persisted for15 minutes and which
immediately followed another 15 minute seizure. What is the priority action for this
patient? - Answer-✅Administer lorazepam and monitor cardiorespiratory status
/.A patient with a seizure disorder has seizures which begin with eye twitching and
occasionally visual hallucinations. Which site in the brain is the seizure focus? - Answer-
✅Occipital
,/.Which drug is used to treat patients with focal epilepsy and complex partial seizures? -
Answer-✅Carbamazepine
/.A patient reports paroxysms of burning, shock-like pain on both sides of the face
usually triggered by chewing or talking. The provider suspects trigeminal neuralgia.
Based on these presenting symptoms, what testing is indicated? - Answer-✅Magnetic
resonance imaging
/.A patient with trigeminal neuralgia has tried several medication regimens to control
pain without success. What is the next step in management for this condition? - Answer-
✅Referral to a neurosurgeon
/.A patient is diagnosed with trigeminal neuralgia and reports having paroxysms several
times each day. What is the initial treatment for this patient? - Answer-✅A high dose of
carbamazepine with subsequent titration downward
/.A patient develops a gait disorder and the patient's spouse reports noticing recent
personality changes. The provider suspects a brain lesion. Which evaluation is
especially important in the initial physical examination? - Answer-✅Examination of the
optic fundi
/.Which is the preferred treatment for primary brain tumors? - Answer-✅Surgical
resection
/.A patient is diagnosed with panic disorder and begins taking a selective serotonin
reuptake inhibitor medication. Six weeks later, the patient reports little relief from
symptoms. What will the provider do next to manage this patient? - Answer-✅Refer to a
mental health provider
/.Which medication are useful in treating both obsessive-compulsive disorder and
PTSD?
Select all that apply. - Answer-✅Selective serotonin reuptake inhibitors
Serotonin-norepinephrine reuptake inhibitors
Tricyclic antidepressants
/.A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The
provider determines that these symptoms occur in relation to many events and
concerns. What other things will the provider question this patient about? - Answer-
✅Headaches and bowel habits
/.A patient is seen in clinic 2 weeks after the death of a parent. The patient reports
feelings of sadness and hopelessness and a feeling that the parent is still present, even
to the point of hearing the parent's voice at times. What will the provider determine from
these findings? - Answer-✅These are normal grief responses.
, /.A college student is brought to clinic by a parent who is concerned about increasingly
bizarre behavior and poor school performance. The provider notes difficulty engaging
the patient in an organized conversation. The patient denies any concerns about
behavior. What will the provider do initially to manage this patient's symptoms? -
Answer-✅Begin treatment with lithium or lamotrigine
/.A patient is seen frequently over a 9-month period with somatic complaints that are not
related to physical disease. The primary provider notes that the patient has had a 15%
weight loss in the previous 2 months and the patient reports difficulty sleeping. The
spouse tells the provider that the patient seems tired all the time and is irritable with
other family members. What will the provider do initially? - Answer-✅Perform a suicide
risk assessment
/.A patient is brought to the emergency department who is experiencing disorientation,
confusion, and fever. The patient describes visual and auditory hallucinations. The
patient's spouse states that the patient had several drinks 12 hours prior to passing out.
A blood alcohol level is 0.2%. What is the recommended treatment? - Answer-
✅Benzodiazepines
/.A college student is brought to the emergency department by a roommate who is
concerned about symptoms of extreme restlessness, nausea, and vomiting. The
provider notes elevations of the pulse and blood pressure and pupillary dilation, along
with hyperactive bowel sounds. The provider suspects withdrawal from which
substance? - Answer-✅Opioids
/.A 17-year-old male is brought to the clinic by a parent who is concerned that the
patient has become more isolated and withdrawn and expresses suspicions that his
teachers hate him and want him to fail. What will the provider tell this parent? - Answer-
✅The adolescent should be evaluated by a psychiatrist.
/.A young male patient is reported to be more withdrawn from his peers than usual and
has dropped out of college and quit his job within the last 5 months. The parent is
concerned that the patient may have schizophrenia because a maternal uncle has the
disease. What will the provider do next? - Answer-✅Ask about the patient's speech and
thinking patterns
/.Which are considered "negative" symptoms of schizophrenia?
Select all that apply. - Answer-✅Impaired self care
Poor school performance
Withdrawing from peers
/.When prescribing medications to an 80-year-old patient, the provider will - Answer-
✅consult the Beers list to help identify potentially problematic drugs.
