CEA Advanced Nursing Practice Quiz
Questions and Answers
1. When evaluating a 78-year-old man, the PMHNP notices the patient
frequent- ly leans in with the right side of his head and frequently
asks for things to be repeated. His daughter is very worried that he
has dementia or depression be- cause he has also become
increasingly isolated, as well as increasingly irritable as he believes
people are yelling at him out of frustration of not being heard.
The daughter is tearful, anxious, and frustrated. What should the
PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview
him alone Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter:
Examine the patient's ear canals
2. A 35-year-old man diagnosed with bipolar disorder mentions to his
PMHNP that he had felt a lump on his left testicle. He is
concerned he has not had a physical exam in 10 years. What is
the best action by the PMHNP?
Explore the reason for not having had a physical in so
,long Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology: Explore the reason for not having had a physical in so long
3. In observing the appearance of the patient with depression and
a history of systemic lupus erythematosus, the PMHNP notices a lesion
on the neck of the patient about the size of a pencil eraser, flush with
the skin, uniformly colored, with discrete borders, and consistent
texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology: Watch and wait
4. Which of the following best represent the physical exam maneuver
known as Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg
up to the chest. A positive test occurs when pain prohibits elevation of
the ipsilateral leg.
The examiner palpates in the right upper abdominal quadrant below the
costal margin while the patient breathes in. The test is positive if
the examiner observes pain during inhalation.
, Press and palpate deeply into the abdomen and release quickly
observing for pain.
Ask the patient to bend at the knees while holding onto a rail,
observe for a loss of balance.: The examiner palpates in the right upper abdominal
quadrant below the costal margin while the patient breathes in. The test is positive if the examiner
observes pain during inhalation.
Acute cholecystitis
5. What does the Murphy sign assess for: Cholecystitis
6. A 26-year-old man has been on an antipsychotic. He requires
further titration for control of symptoms. Which of the following
tests should be repeated? EKG
Head CT scan
Liver function
test Urinalysis:
EKG
7. Your client Jamie asks you about a mole of her forearm. You
refer her to dermatology. As an APRN, you recognize that cancerous
moles can be detected on exam. Which of the following would not
be of concern?
Questions and Answers
1. When evaluating a 78-year-old man, the PMHNP notices the patient
frequent- ly leans in with the right side of his head and frequently
asks for things to be repeated. His daughter is very worried that he
has dementia or depression be- cause he has also become
increasingly isolated, as well as increasingly irritable as he believes
people are yelling at him out of frustration of not being heard.
The daughter is tearful, anxious, and frustrated. What should the
PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview
him alone Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter:
Examine the patient's ear canals
2. A 35-year-old man diagnosed with bipolar disorder mentions to his
PMHNP that he had felt a lump on his left testicle. He is
concerned he has not had a physical exam in 10 years. What is
the best action by the PMHNP?
Explore the reason for not having had a physical in so
,long Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology: Explore the reason for not having had a physical in so long
3. In observing the appearance of the patient with depression and
a history of systemic lupus erythematosus, the PMHNP notices a lesion
on the neck of the patient about the size of a pencil eraser, flush with
the skin, uniformly colored, with discrete borders, and consistent
texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology: Watch and wait
4. Which of the following best represent the physical exam maneuver
known as Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg
up to the chest. A positive test occurs when pain prohibits elevation of
the ipsilateral leg.
The examiner palpates in the right upper abdominal quadrant below the
costal margin while the patient breathes in. The test is positive if
the examiner observes pain during inhalation.
, Press and palpate deeply into the abdomen and release quickly
observing for pain.
Ask the patient to bend at the knees while holding onto a rail,
observe for a loss of balance.: The examiner palpates in the right upper abdominal
quadrant below the costal margin while the patient breathes in. The test is positive if the examiner
observes pain during inhalation.
Acute cholecystitis
5. What does the Murphy sign assess for: Cholecystitis
6. A 26-year-old man has been on an antipsychotic. He requires
further titration for control of symptoms. Which of the following
tests should be repeated? EKG
Head CT scan
Liver function
test Urinalysis:
EKG
7. Your client Jamie asks you about a mole of her forearm. You
refer her to dermatology. As an APRN, you recognize that cancerous
moles can be detected on exam. Which of the following would not
be of concern?
