FNP 654 Midterm Exam | Family Primary Care II – 160
Practice Questions Latest Update | Grand Canyon
University | Bold Answers with Explanations |
INSTANT PDF DOWNLOAD
Introduction
This comprehensive practice exam is designed for students preparing for the FNP 654
Midterm Exam: Family Primary Care II at Grand Canyon University (GCU) . This
midterm covers advanced primary care topics including:
Neurologic Disorders – ALS, Bell's palsy, Guillain-Barré syndrome, headaches,
multiple sclerosis, seizure disorders, Parkinson's disease, trigeminal neuralgia, brain
tumors
Psychiatric/Mental Health – Panic disorder, OCD, PTSD, schizophrenia,
depression, anxiety, suicide risk assessment
Reproductive Health – Amenorrhea, pelvic inflammatory disease, chronic pelvic
pain, dysmenorrhea, Bartholin's cyst, menopause, breast cancer, BRCA mutations
Endocrine Disorders – Addison's disease, Cushing's syndrome,
hyperparathyroidism, pituitary adenoma
Oncology – Cancer pain management, chemotherapy complications, inflammatory
breast cancer
, Special Populations – Pediatric assessment, adolescent mental health, geriatric
considerations
Each question includes the correct answer in bold and a detailed rationale.
Section 1: Neurologic Disorders (Questions 1-40)
1. 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?
A. Upper motor neurons
B. Lower motor neurons
C. Cerebellar pathways
D. Sensory neurons
Rationale: ALS is characterized by both upper and lower motor neuron signs, but
asymmetric weakness in the arms and difficulty walking are classic signs of lower motor
neuron involvement .
2. 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?
A. The patient will need to be hospitalized immediately
B. Respiratory support is the only concern
C. Preventing malnutrition is a key element in care
D. The disease is curable with early treatment
,Rationale: As ALS progresses, patients develop difficulty swallowing, making nutrition
a critical aspect of care. Preventing malnutrition and aspiration is essential for maintaining
quality of life .
3. Which symptoms may occur with Bell's palsy? (Select all that apply)
A. Alteration in taste
B. Drooling
C. Tinnitus
D. Bilateral facial paralysis
E. Leg weakness
Rationale: Bell's palsy is unilateral facial nerve paralysis. Symptoms include alteration
in taste (CN VII carries taste fibers), drooling (due to facial muscle weakness), and tinnitus
(due to involvement of the stapedius muscle) .
4. 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 unilateral full
face paralysis on the right side. What is the initial intervention for this patient?
A. Refer to neurology immediately
B. Prescribe oral prednisolone
C. Prescribe antibiotics
D. Schedule MRI of the brain
Rationale: Bell's palsy is treated with a tapering course of oral corticosteroids
(prednisolone) to reduce inflammation of the facial nerve. Antivirals may be added if a viral
cause is strongly suspected .
, 5. What is recommended to prevent ophthalmic complications in patients with Bell's
palsy?
A. Lubricating eye drops
B. Sunglasses
C. Eye patch at all times
D. Topical steroids
Rationale: Inability to close the eye due to facial paralysis can lead to corneal drying
and ulceration. Lubricating eye drops and artificial tears help prevent these complications .
6. 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?
A. CT scan of the head
B. MRI of the brain
C. The Hallpike-Dix positioning maneuver
D. Audiometry
Rationale: The Hallpike-Dix maneuver is used to diagnose benign paroxysmal
positional vertigo (BPPV) by provoking nystagmus and vertigo with specific head
positioning .
7. Which diagnostic test helps confirm a diagnosis of Guillain-Barré syndrome in a
patient who is developing muscle weakness and paresthesias?
A. CT scan
B. MRI
C. Lumbar puncture
D. EEG
Practice Questions Latest Update | Grand Canyon
University | Bold Answers with Explanations |
INSTANT PDF DOWNLOAD
Introduction
This comprehensive practice exam is designed for students preparing for the FNP 654
Midterm Exam: Family Primary Care II at Grand Canyon University (GCU) . This
midterm covers advanced primary care topics including:
Neurologic Disorders – ALS, Bell's palsy, Guillain-Barré syndrome, headaches,
multiple sclerosis, seizure disorders, Parkinson's disease, trigeminal neuralgia, brain
tumors
Psychiatric/Mental Health – Panic disorder, OCD, PTSD, schizophrenia,
depression, anxiety, suicide risk assessment
Reproductive Health – Amenorrhea, pelvic inflammatory disease, chronic pelvic
pain, dysmenorrhea, Bartholin's cyst, menopause, breast cancer, BRCA mutations
Endocrine Disorders – Addison's disease, Cushing's syndrome,
hyperparathyroidism, pituitary adenoma
Oncology – Cancer pain management, chemotherapy complications, inflammatory
breast cancer
, Special Populations – Pediatric assessment, adolescent mental health, geriatric
considerations
Each question includes the correct answer in bold and a detailed rationale.
Section 1: Neurologic Disorders (Questions 1-40)
1. 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?
A. Upper motor neurons
B. Lower motor neurons
C. Cerebellar pathways
D. Sensory neurons
Rationale: ALS is characterized by both upper and lower motor neuron signs, but
asymmetric weakness in the arms and difficulty walking are classic signs of lower motor
neuron involvement .
2. 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?
A. The patient will need to be hospitalized immediately
B. Respiratory support is the only concern
C. Preventing malnutrition is a key element in care
D. The disease is curable with early treatment
,Rationale: As ALS progresses, patients develop difficulty swallowing, making nutrition
a critical aspect of care. Preventing malnutrition and aspiration is essential for maintaining
quality of life .
3. Which symptoms may occur with Bell's palsy? (Select all that apply)
A. Alteration in taste
B. Drooling
C. Tinnitus
D. Bilateral facial paralysis
E. Leg weakness
Rationale: Bell's palsy is unilateral facial nerve paralysis. Symptoms include alteration
in taste (CN VII carries taste fibers), drooling (due to facial muscle weakness), and tinnitus
(due to involvement of the stapedius muscle) .
4. 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 unilateral full
face paralysis on the right side. What is the initial intervention for this patient?
A. Refer to neurology immediately
B. Prescribe oral prednisolone
C. Prescribe antibiotics
D. Schedule MRI of the brain
Rationale: Bell's palsy is treated with a tapering course of oral corticosteroids
(prednisolone) to reduce inflammation of the facial nerve. Antivirals may be added if a viral
cause is strongly suspected .
, 5. What is recommended to prevent ophthalmic complications in patients with Bell's
palsy?
A. Lubricating eye drops
B. Sunglasses
C. Eye patch at all times
D. Topical steroids
Rationale: Inability to close the eye due to facial paralysis can lead to corneal drying
and ulceration. Lubricating eye drops and artificial tears help prevent these complications .
6. 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?
A. CT scan of the head
B. MRI of the brain
C. The Hallpike-Dix positioning maneuver
D. Audiometry
Rationale: The Hallpike-Dix maneuver is used to diagnose benign paroxysmal
positional vertigo (BPPV) by provoking nystagmus and vertigo with specific head
positioning .
7. Which diagnostic test helps confirm a diagnosis of Guillain-Barré syndrome in a
patient who is developing muscle weakness and paresthesias?
A. CT scan
B. MRI
C. Lumbar puncture
D. EEG
