FNP 652 Final Exam Version 2 Newest Actual Exam With Complete Questions
And Correct Detailed Answers (Verified Answers) |Already Graded A+
Question 1
A 5-year-old child is hit in the face with a baseball bat and presents with three avulsed front
teeth. Radiologic studies are negative for facial fractures. What is the recommended treatment?
A) Reimplant the teeth immediately in the clinic
B) Refer the child to the dentist immediately for further evaluation
C) Administer prophylactic antibiotics and follow up in one week
D) Tell the parents that primary teeth are not replaced and no action is needed
E) Place the teeth in milk and wait for the child to see a primary care provider in 48 hours
Correct Answer: B) Refer the child to the dentist immediately for further evaluation
Rationale: Avulsed teeth are a dental emergency. Even if they are primary teeth, a dentist
must evaluate the alveolar bone and ensure no fragments are remaining or that there is no
damage to the permanent tooth buds.
Question 2
A child previously treated with amoxicillin and then amoxicillin-clavulanate for acute otitis
media (AOM) presents for follow-up. The NP notes dull-gray tympanic membranes with visible
air-fluid levels. The child is afebrile and without pain. What is the next course of action?
A) Start a course of Ceftriaxone
B) Refer for immediate tympanostomy tubes
C) Monitoring ear fluid levels for 3 months
D) Prescribe a 10-day course of steroids
E) Perform a needle aspiration of the middle ear
Correct Answer: C) Monitoring ear fluid levels for 3 months
Rationale: This presentation describes Otitis Media with Effusion (OME). In an
asymptomatic child following AOM, OME usually resolves spontaneously and should be
monitored for 3 months before considering surgical intervention.
Question 3
A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube. What should the NP
recommend to promote dental health in this child?
A) Increased intake of sugary liquids via G-tube
B) Daily chlorhexidine gluconate
C) Professional cleaning every 2 years
D) Avoidance of all fluoride products
E) Brushing only once per week
Correct Answer: B) Daily chlorhexidine gluconate
Rationale: Children with G-tubes often have increased calculus formation and gingivitis due
to lack of oral stimulation and salivary flow changes. Chlorhexidine gluconate helps reduce
the bacterial load and plaque.
, 2
Question 4
A primary care provider may suspect cataract formation in a patient with which clinical finding?
A) Excessive tearing and photophobia
B) Sudden loss of peripheral vision
C) Asymmetric red reflex
D) Purulent discharge from the lacrimal duct
E) Increased intraocular pressure
Correct Answer: C) Asymmetric red reflex
Rationale: Cataracts cause opacification of the lens, which interferes with the red reflex. An
asymmetric or absent red reflex is a hallmark sign that requires an ophthalmology referral.
Question 5
A patient presents with chronically dry eyes, foreign body sensation, burning, and itching. A
Schirmer test is performed and returns an abnormal result. What is the suspected cause?
A) Bacterial infection
B) Aqueous Deficiency
C) Excess lipid production
D) Corneal abrasion
E) Vitamin A toxicity
Correct Answer: B) Aqueous Deficiency
Rationale: The Schirmer test measures tear production. An abnormal result (low moisture
on the filter paper) indicates a deficiency in the aqueous layer of the tear film.
Question 6
A teenager with otitis externa has severe swelling of the external auditory canal that persists after
2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step in
treatment?
A) Change the drops to a systemic antibiotic
B) Refer for a CT scan of the temporal bone
C) Insert a wick into the external auditory canal
D) Irrigate the ear with high-pressure saline
E) Discontinue all treatment and observe
Correct Answer: C) Insert a wick into the external auditory canal
Rationale: When the canal is severely edematous, topical drops cannot reach the distal
portion of the canal. An ear wick facilitates the delivery of the medication through the
swelling.
Question 7
A patient reports tooth pain in a lower molar. The provider notes a mobile tooth with erythema
and edema of the surrounding tissues but no discharge. What is the initial course of action?
A) Extract the tooth in the office
, 3
B) Prescribe amoxicillin and refer to a dentist in 2-3 days
C) Apply topical lidocaine and observe for 1 week
D) Order a facial MRI
E) Perform an incision and drainage immediately
Correct Answer: B) Prescribe amoxicillin and refer to a dentist in 2-3 days
Rationale: Signs of localized infection (pain, mobility, erythema) require antibiotic coverage
to prevent systemic spread and a prompt referral to a dentist for definitive treatment.
Question 8
An elderly patient presents with a permanent loss of the sense of smell and diminished taste.
Which of the following is an important teaching point for managing these symptoms?
A) The importance of installing smoke detectors
B) Reducing the frequency of dental visits
C) Increasing the use of salt to enhance flavor
D) Avoiding all spicy foods
E) Relying on smell to determine if food is spoiled
Correct Answer: A) The importance of installing smoke detectors
Rationale: Anosmia (loss of smell) is a safety risk because the patient cannot smell smoke or
gas leaks. Smoke detectors and checking food expiration dates are critical safety measures.
Question 9
A toddler exhibits exotropia of the right eye during a cover-uncover screen. To which specialist
should the NP refer, and what is the likely initial treatment?
A) Neurologist; MRI of the brain
B) Pediatric ophthalmologist; Patching of the unaffected eye for 2 hours each day
C) Optometrist; Reading glasses
D) Surgeon; Immediate eye muscle surgery
E) Physical therapist; Neck strengthening exercises
Correct Answer: B) Pediatric ophthalmologist; Patching of the unaffected eye for 2 hours
each day
Rationale: Exotropia is a form of strabismus. Patching the "strong" or unaffected eye forces
the brain to use the "weak" eye, preventing amblyopia (lazy eye).
Question 10
An adolescent has localized bleeding of the gums when brushing. An exam reveals plaque and
calculus on the teeth, but the teeth are not loose. What is the primary recommendation?
A) Start oral antibiotics for 14 days
B) Consistently brushing and flossing the teeth twice daily
C) Switch to a hard-bristled toothbrush
D) Stop brushing until the bleeding subsides
E) Refer for immediate tooth extraction
, 4
Correct Answer: B) Consistently brushing and flossing the teeth twice daily
Rationale: The symptoms describe gingivitis caused by plaque buildup. Mechanical removal
via brushing and flossing is the standard treatment to reverse gum inflammation.
Question 11
A provider is recommending a cerumenolytic for a patient with chronic cerumen buildup and dry
skin in the ear canal. Which preparation is FDA approved for this use?
A) Hydrogen peroxide (3%)
B) Mineral oil
C) Carbamide peroxide
D) Acetic acid
E) Isopropyl alcohol
Correct Answer: C) Carbamide peroxide
Rationale: Carbamide peroxide is the FDA-approved over-the-counter cerumenolytic used
to soften and help remove earwax.
Question 12
A parent asks for a convenient way to promote dental health in school-aged children while
camping and picnicking. What should the NP recommend?
A) Avoid all snacks between meals
B) Rinsing with soda after eating
C) Offering gum containing xylitol after meals
D) Brushing only at the end of the vacation
E) Using a toothpick after every meal
Correct Answer: C) Offering gum containing xylitol after meals
Rationale: Xylitol is a sugar alcohol that inhibits the growth of Streptococcus mutans, the
primary bacteria responsible for tooth decay.
Question 13
A patient reports several episodes of acute vertigo lasting up to an hour with associated nausea
and vomiting. What is part of the initial diagnostic workup for this patient?
A) Chest X-ray and EKG
B) Audiogram and MRI
C) Complete Blood Count (CBC) only
D) Thyroid Stimulating Hormone (TSH)
E) Carotid ultrasound
Correct Answer: B) Audiogram and MRI
Rationale: The differential includes Meniere's disease and acoustic neuroma. An audiogram
checks for hearing loss, and an MRI of the internal auditory canal rules out structural
tumors.
And Correct Detailed Answers (Verified Answers) |Already Graded A+
Question 1
A 5-year-old child is hit in the face with a baseball bat and presents with three avulsed front
teeth. Radiologic studies are negative for facial fractures. What is the recommended treatment?
A) Reimplant the teeth immediately in the clinic
B) Refer the child to the dentist immediately for further evaluation
C) Administer prophylactic antibiotics and follow up in one week
D) Tell the parents that primary teeth are not replaced and no action is needed
E) Place the teeth in milk and wait for the child to see a primary care provider in 48 hours
Correct Answer: B) Refer the child to the dentist immediately for further evaluation
Rationale: Avulsed teeth are a dental emergency. Even if they are primary teeth, a dentist
must evaluate the alveolar bone and ensure no fragments are remaining or that there is no
damage to the permanent tooth buds.
Question 2
A child previously treated with amoxicillin and then amoxicillin-clavulanate for acute otitis
media (AOM) presents for follow-up. The NP notes dull-gray tympanic membranes with visible
air-fluid levels. The child is afebrile and without pain. What is the next course of action?
A) Start a course of Ceftriaxone
B) Refer for immediate tympanostomy tubes
C) Monitoring ear fluid levels for 3 months
D) Prescribe a 10-day course of steroids
E) Perform a needle aspiration of the middle ear
Correct Answer: C) Monitoring ear fluid levels for 3 months
Rationale: This presentation describes Otitis Media with Effusion (OME). In an
asymptomatic child following AOM, OME usually resolves spontaneously and should be
monitored for 3 months before considering surgical intervention.
Question 3
A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube. What should the NP
recommend to promote dental health in this child?
A) Increased intake of sugary liquids via G-tube
B) Daily chlorhexidine gluconate
C) Professional cleaning every 2 years
D) Avoidance of all fluoride products
E) Brushing only once per week
Correct Answer: B) Daily chlorhexidine gluconate
Rationale: Children with G-tubes often have increased calculus formation and gingivitis due
to lack of oral stimulation and salivary flow changes. Chlorhexidine gluconate helps reduce
the bacterial load and plaque.
, 2
Question 4
A primary care provider may suspect cataract formation in a patient with which clinical finding?
A) Excessive tearing and photophobia
B) Sudden loss of peripheral vision
C) Asymmetric red reflex
D) Purulent discharge from the lacrimal duct
E) Increased intraocular pressure
Correct Answer: C) Asymmetric red reflex
Rationale: Cataracts cause opacification of the lens, which interferes with the red reflex. An
asymmetric or absent red reflex is a hallmark sign that requires an ophthalmology referral.
Question 5
A patient presents with chronically dry eyes, foreign body sensation, burning, and itching. A
Schirmer test is performed and returns an abnormal result. What is the suspected cause?
A) Bacterial infection
B) Aqueous Deficiency
C) Excess lipid production
D) Corneal abrasion
E) Vitamin A toxicity
Correct Answer: B) Aqueous Deficiency
Rationale: The Schirmer test measures tear production. An abnormal result (low moisture
on the filter paper) indicates a deficiency in the aqueous layer of the tear film.
Question 6
A teenager with otitis externa has severe swelling of the external auditory canal that persists after
2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step in
treatment?
A) Change the drops to a systemic antibiotic
B) Refer for a CT scan of the temporal bone
C) Insert a wick into the external auditory canal
D) Irrigate the ear with high-pressure saline
E) Discontinue all treatment and observe
Correct Answer: C) Insert a wick into the external auditory canal
Rationale: When the canal is severely edematous, topical drops cannot reach the distal
portion of the canal. An ear wick facilitates the delivery of the medication through the
swelling.
Question 7
A patient reports tooth pain in a lower molar. The provider notes a mobile tooth with erythema
and edema of the surrounding tissues but no discharge. What is the initial course of action?
A) Extract the tooth in the office
, 3
B) Prescribe amoxicillin and refer to a dentist in 2-3 days
C) Apply topical lidocaine and observe for 1 week
D) Order a facial MRI
E) Perform an incision and drainage immediately
Correct Answer: B) Prescribe amoxicillin and refer to a dentist in 2-3 days
Rationale: Signs of localized infection (pain, mobility, erythema) require antibiotic coverage
to prevent systemic spread and a prompt referral to a dentist for definitive treatment.
Question 8
An elderly patient presents with a permanent loss of the sense of smell and diminished taste.
Which of the following is an important teaching point for managing these symptoms?
A) The importance of installing smoke detectors
B) Reducing the frequency of dental visits
C) Increasing the use of salt to enhance flavor
D) Avoiding all spicy foods
E) Relying on smell to determine if food is spoiled
Correct Answer: A) The importance of installing smoke detectors
Rationale: Anosmia (loss of smell) is a safety risk because the patient cannot smell smoke or
gas leaks. Smoke detectors and checking food expiration dates are critical safety measures.
Question 9
A toddler exhibits exotropia of the right eye during a cover-uncover screen. To which specialist
should the NP refer, and what is the likely initial treatment?
A) Neurologist; MRI of the brain
B) Pediatric ophthalmologist; Patching of the unaffected eye for 2 hours each day
C) Optometrist; Reading glasses
D) Surgeon; Immediate eye muscle surgery
E) Physical therapist; Neck strengthening exercises
Correct Answer: B) Pediatric ophthalmologist; Patching of the unaffected eye for 2 hours
each day
Rationale: Exotropia is a form of strabismus. Patching the "strong" or unaffected eye forces
the brain to use the "weak" eye, preventing amblyopia (lazy eye).
Question 10
An adolescent has localized bleeding of the gums when brushing. An exam reveals plaque and
calculus on the teeth, but the teeth are not loose. What is the primary recommendation?
A) Start oral antibiotics for 14 days
B) Consistently brushing and flossing the teeth twice daily
C) Switch to a hard-bristled toothbrush
D) Stop brushing until the bleeding subsides
E) Refer for immediate tooth extraction
, 4
Correct Answer: B) Consistently brushing and flossing the teeth twice daily
Rationale: The symptoms describe gingivitis caused by plaque buildup. Mechanical removal
via brushing and flossing is the standard treatment to reverse gum inflammation.
Question 11
A provider is recommending a cerumenolytic for a patient with chronic cerumen buildup and dry
skin in the ear canal. Which preparation is FDA approved for this use?
A) Hydrogen peroxide (3%)
B) Mineral oil
C) Carbamide peroxide
D) Acetic acid
E) Isopropyl alcohol
Correct Answer: C) Carbamide peroxide
Rationale: Carbamide peroxide is the FDA-approved over-the-counter cerumenolytic used
to soften and help remove earwax.
Question 12
A parent asks for a convenient way to promote dental health in school-aged children while
camping and picnicking. What should the NP recommend?
A) Avoid all snacks between meals
B) Rinsing with soda after eating
C) Offering gum containing xylitol after meals
D) Brushing only at the end of the vacation
E) Using a toothpick after every meal
Correct Answer: C) Offering gum containing xylitol after meals
Rationale: Xylitol is a sugar alcohol that inhibits the growth of Streptococcus mutans, the
primary bacteria responsible for tooth decay.
Question 13
A patient reports several episodes of acute vertigo lasting up to an hour with associated nausea
and vomiting. What is part of the initial diagnostic workup for this patient?
A) Chest X-ray and EKG
B) Audiogram and MRI
C) Complete Blood Count (CBC) only
D) Thyroid Stimulating Hormone (TSH)
E) Carotid ultrasound
Correct Answer: B) Audiogram and MRI
Rationale: The differential includes Meniere's disease and acoustic neuroma. An audiogram
checks for hearing loss, and an MRI of the internal auditory canal rules out structural
tumors.
