Fnp 654 Final Exam Questions And Answers
2025 Graded A Success Assured
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?
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?
Preventing malnutrition is a key element in care.
Which symptoms may occur with Bell's palsy?
Select all that apply.
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?
Prescribe oral prednisolone
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?
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?
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?
Neurologist
Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is
developing muscle weakness and paresthesias?
,Lumbar puncture
Which monitoring parameters are necessary when caring for a patient with Guillain-Barre
syndrome?
Select all that apply.
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?
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?
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?
Rizatriptan
Which medications may be useful in treating tension-type headache?
Select all that apply.
Antiemetics
Muscle relaxants
NSAIDs
A provider suspects that a patient has bacterial meningitis. When should antibiotics be given?
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?
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?
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
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?
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?
Occipital
Which drug is used to treat patients with focal epilepsy and complex partial seizures?
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?
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?
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?
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?
Examination of the optic fundi
, Which jis jthe jpreferred jtreatment jfor jprimary jbrain jtumors?
Surgical jresection
A jpatient jis jdiagnosed jwith jpanic jdisorder jand jbegins jtaking ja jselective jserotonin jreuptake
jinhibitor jmedication. jSix jweeks jlater, jthe jpatient jreports jlittle jrelief jfrom jsymptoms. jWhat jwill
jthe jprovider jdo jnext jto jmanage jthis jpatient?
Refer jto ja jmental jhealth jprovider
Which jmedication jare juseful jin jtreating jboth jobsessive-compulsive jdisorder jand jPTSD?
jSelect jall jthat japply.
Selective jserotonin jreuptake jinhibitors
jSerotonin-norepinephrine jreuptake jinhibitors
jTricyclic jantidepressants
A jpatient jreports jsymptoms jof jrestlessness, jfatigue, jand jdifficulty jconcentrating. jThe jprovider
jdetermines jthat jthese jsymptoms joccur jin jrelation jto jmany jevents jand jconcerns. jWhat jother
jthings jwill jthe jprovider jquestion jthis jpatient jabout?
Headaches jand jbowel jhabits
A jpatient jis jseen jin jclinic j2 jweeks jafter jthe jdeath jof ja jparent. jThe jpatient jreports jfeelings jof
jsadness jand jhopelessness jand ja jfeeling jthat jthe jparent jis jstill jpresent, jeven jto jthe jpoint jof jhearing
jthe jparent's jvoice jat jtimes. jWhat jwill jthe jprovider jdetermine jfrom jthese jfindings?
These jare jnormal jgrief jresponses.
A jcollege jstudent jis jbrought jto jclinic jby ja jparent jwho jis jconcerned jabout jincreasingly jbizarre
jbehavior jand jpoor jschool jperformance. jThe jprovider jnotes jdifficulty jengaging jthe jpatient jin jan
jorganized jconversation. jThe jpatient jdenies jany jconcerns jabout jbehavior. jWhat jwill jthe jprovider
jdo jinitially jto jmanage jthis jpatient's jsymptoms?
Begin jtreatment jwith jlithium jor jlamotrigine
A jpatient jis jseen jfrequently jover ja j9-month jperiod jwith jsomatic jcomplaints jthat jare jnot jrelated jto
jphysical jdisease. jThe jprimary jprovider jnotes jthat jthe jpatient jhas jhad ja j15% jweight jloss jin jthe
jprevious j2 jmonths jand jthe jpatient jreports jdifficulty jsleeping. jThe jspouse jtells jthe jprovider jthat
jthe jpatient jseems jtired jall jthe jtime jand jis jirritable jwith jother jfamily jmembers. jWhat jwill jthe
jprovider jdo jinitially?
Perform ja jsuicide jrisk jassessment
A jpatient jis jbrought jto jthe jemergency jdepartment jwho jis jexperiencing jdisorientation, jconfusion,
jand jfever. jThe jpatient jdescribes jvisual jand jauditory jhallucinations. jThe jpatient's jspouse jstates
2025 Graded A Success Assured
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?
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?
Preventing malnutrition is a key element in care.
Which symptoms may occur with Bell's palsy?
Select all that apply.
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?
Prescribe oral prednisolone
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?
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?
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?
Neurologist
Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is
developing muscle weakness and paresthesias?
,Lumbar puncture
Which monitoring parameters are necessary when caring for a patient with Guillain-Barre
syndrome?
Select all that apply.
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?
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?
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?
Rizatriptan
Which medications may be useful in treating tension-type headache?
Select all that apply.
Antiemetics
Muscle relaxants
NSAIDs
A provider suspects that a patient has bacterial meningitis. When should antibiotics be given?
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?
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?
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
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?
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?
Occipital
Which drug is used to treat patients with focal epilepsy and complex partial seizures?
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?
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?
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?
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?
Examination of the optic fundi
, Which jis jthe jpreferred jtreatment jfor jprimary jbrain jtumors?
Surgical jresection
A jpatient jis jdiagnosed jwith jpanic jdisorder jand jbegins jtaking ja jselective jserotonin jreuptake
jinhibitor jmedication. jSix jweeks jlater, jthe jpatient jreports jlittle jrelief jfrom jsymptoms. jWhat jwill
jthe jprovider jdo jnext jto jmanage jthis jpatient?
Refer jto ja jmental jhealth jprovider
Which jmedication jare juseful jin jtreating jboth jobsessive-compulsive jdisorder jand jPTSD?
jSelect jall jthat japply.
Selective jserotonin jreuptake jinhibitors
jSerotonin-norepinephrine jreuptake jinhibitors
jTricyclic jantidepressants
A jpatient jreports jsymptoms jof jrestlessness, jfatigue, jand jdifficulty jconcentrating. jThe jprovider
jdetermines jthat jthese jsymptoms joccur jin jrelation jto jmany jevents jand jconcerns. jWhat jother
jthings jwill jthe jprovider jquestion jthis jpatient jabout?
Headaches jand jbowel jhabits
A jpatient jis jseen jin jclinic j2 jweeks jafter jthe jdeath jof ja jparent. jThe jpatient jreports jfeelings jof
jsadness jand jhopelessness jand ja jfeeling jthat jthe jparent jis jstill jpresent, jeven jto jthe jpoint jof jhearing
jthe jparent's jvoice jat jtimes. jWhat jwill jthe jprovider jdetermine jfrom jthese jfindings?
These jare jnormal jgrief jresponses.
A jcollege jstudent jis jbrought jto jclinic jby ja jparent jwho jis jconcerned jabout jincreasingly jbizarre
jbehavior jand jpoor jschool jperformance. jThe jprovider jnotes jdifficulty jengaging jthe jpatient jin jan
jorganized jconversation. jThe jpatient jdenies jany jconcerns jabout jbehavior. jWhat jwill jthe jprovider
jdo jinitially jto jmanage jthis jpatient's jsymptoms?
Begin jtreatment jwith jlithium jor jlamotrigine
A jpatient jis jseen jfrequently jover ja j9-month jperiod jwith jsomatic jcomplaints jthat jare jnot jrelated jto
jphysical jdisease. jThe jprimary jprovider jnotes jthat jthe jpatient jhas jhad ja j15% jweight jloss jin jthe
jprevious j2 jmonths jand jthe jpatient jreports jdifficulty jsleeping. jThe jspouse jtells jthe jprovider jthat
jthe jpatient jseems jtired jall jthe jtime jand jis jirritable jwith jother jfamily jmembers. jWhat jwill jthe
jprovider jdo jinitially?
Perform ja jsuicide jrisk jassessment
A jpatient jis jbrought jto jthe jemergency jdepartment jwho jis jexperiencing jdisorientation, jconfusion,
jand jfever. jThe jpatient jdescribes jvisual jand jauditory jhallucinations. jThe jpatient's jspouse jstates
