FNP 654 Final Exam UPDATED
QUESTIONS AND CORRECT ANSWERS
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? - CORRECT
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? - CORRECT
ANSWER Preventing malnutrition is a key element in care.
Which symptoms may occur with Bell's palsy?
Select all that apply. - CORRECT 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? - CORRECT ANSWER Prescribe oral prednisolone
What is recommended to prevent ophthalmic complications in patients with Bell's palsy? - CORRECT
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? - CORRECT 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? - CORRECT
ANSWER Neurologist
Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is
developing muscle weakness and paresthesias? - CORRECT ANSWER Lumbar puncture
Which monitoring parameters are necessary when caring for a patient with Guillain-Barre syndrome?
,Select all that apply. - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER Rizatriptan
Which medications may be useful in treating tension-type headache?
Select all that apply. - CORRECT ANSWER Antiemetics
Muscle relaxants
NSAIDs
A provider suspects that a patient has bacterial meningitis. When should antibiotics be given? -
CORRECT 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? - CORRECT 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? - CORRECT 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 - CORRECT
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? - CORRECT 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? - CORRECT ANSWER Occipital
Which drug is used to treat patients with focal epilepsy and complex partial seizures? - CORRECT
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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER Examination of the optic fundi
Which is the preferred treatment for primary brain tumors? - CORRECT 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? - CORRECT ANSWER Refer to a mental health provider
Which medication are useful in treating both obsessive-compulsive disorder and PTSD?
Select all that apply. - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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
QUESTIONS AND CORRECT ANSWERS
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? - CORRECT
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? - CORRECT
ANSWER Preventing malnutrition is a key element in care.
Which symptoms may occur with Bell's palsy?
Select all that apply. - CORRECT 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? - CORRECT ANSWER Prescribe oral prednisolone
What is recommended to prevent ophthalmic complications in patients with Bell's palsy? - CORRECT
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? - CORRECT 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? - CORRECT
ANSWER Neurologist
Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is
developing muscle weakness and paresthesias? - CORRECT ANSWER Lumbar puncture
Which monitoring parameters are necessary when caring for a patient with Guillain-Barre syndrome?
,Select all that apply. - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER Rizatriptan
Which medications may be useful in treating tension-type headache?
Select all that apply. - CORRECT ANSWER Antiemetics
Muscle relaxants
NSAIDs
A provider suspects that a patient has bacterial meningitis. When should antibiotics be given? -
CORRECT 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? - CORRECT 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? - CORRECT 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 - CORRECT
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? - CORRECT 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? - CORRECT ANSWER Occipital
Which drug is used to treat patients with focal epilepsy and complex partial seizures? - CORRECT
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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT ANSWER Examination of the optic fundi
Which is the preferred treatment for primary brain tumors? - CORRECT 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? - CORRECT ANSWER Refer to a mental health provider
Which medication are useful in treating both obsessive-compulsive disorder and PTSD?
Select all that apply. - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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? - CORRECT 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
