WILKES UNIVERSITY
Master of Science in Nursing (MSN)
NSG 554 Nurse Practitioners in Primary Care I
Academic Year: Exam 1 – Question Bank
Question 1
What is the NP’s responsibility in a case of sexual assault?
Correct answer:
If occurred within previous 5 days (best within 72 hours), refer to ED for best collection
of evidence. Prepare the patient for the examination. Advise patient not to shower, etc. If
longer than 5 days, perform STI testing and treat injuries/wounds as needed.
RATIONALE:
Timely evidence collection is critical for forensic purposes. The ED has the resources for a sexual
assault nurse examiner (SANE) and proper chain of custody. Beyond 5 days, the focus shifts to
medical care including STI prophylaxis, emergency contraception, and follow‑up for
psychological support.
Question 2
What are the three options for emergency contraception?
Correct answer: Plan B (levonorgestrel), Ulipristal acetate (Ella), and the Copper IUD.
RATIONALE:
Emergency contraception prevents pregnancy after unprotected intercourse. Levonorgestrel is
effective up to 72 hours, ulipristal up to 120 hours, and the Copper IUD can be inserted up to 5
days after ovulation. The IUD is the most effective option.
,Question 3
What are the two major categories of cardiac causes of syncope?
Correct answer:
Mechanical/obstructive (e.g., aortic stenosis, hypertrophic cardiomyopathy) and
arrhythmic (more common).
RATIONALE:
Cardiac syncope is the most dangerous form. Arrhythmias (e.g., ventricular tachycardia, heart
block) are the most frequent; mechanical obstruction can reduce cardiac output during exertion.
Both require urgent cardiology evaluation.
Question 4
What are the signs and symptoms of influenza?
Correct answer:
Fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue.
RATIONALE:
Influenza is a viral respiratory illness with sudden onset of systemic symptoms. Fever is usually
high, and myalgias are prominent. Unlike the common cold, influenza tends to cause more
severe constitutional symptoms and can lead to pneumonia, especially in high‑risk groups.
Question 5
What are the three categories of infectious diarrhea?
Correct answer:
Inflammatory, non‑inflammatory, and penetrating gastrointestinal illness.
RATIONALE:
Inflammatory diarrhea involves invasion of the mucosa, producing fever and bloody stools.
Non‑inflammatory is watery and usually self‑limited. Penetrating illness can cause systemic
symptoms and may affect the small intestine, leading to malabsorption.
, Question 6
For whom is the herpes zoster (shingles) vaccine recommended?
Correct answer: Adults ≥50 years of age.
RATIONALE:
The risk of shingles and post‑herpetic neuralgia increases with age. The recombinant zoster
vaccine (Shingrix) is preferred over the live vaccine (Zostavax) and has higher efficacy. Two
doses are given 2‑6 months apart.
Question 7
In which unstable patients with tachycardia is cardioversion used?
Correct answer:
Stable atrial fibrillation, atrial flutter, and monomorphic ventricular tachycardia.
RATIONALE:
Cardioversion is a synchronized electrical shock used to restore normal sinus rhythm in
tachyarrhythmias with a discernible QRS complex. It is indicated in unstable patients or those
who do not respond to medications. Defibrillation is used for pulseless ventricular tachycardia
or ventricular fibrillation.
Question 8
What scale is used to measure severity of head trauma, and what three categories does it
score?
Correct answer:
Glasgow Coma Scale (GCS) – highest score is 15. It scores Eye Opening, Best Motor
Response, and Best Verbal Response.
RATIONALE:
The GCS is a standardized tool to assess level of consciousness. Scores range from 3 to 15. It is
used to guide clinical management and predict outcomes in traumatic brain injury.
Master of Science in Nursing (MSN)
NSG 554 Nurse Practitioners in Primary Care I
Academic Year: Exam 1 – Question Bank
Question 1
What is the NP’s responsibility in a case of sexual assault?
Correct answer:
If occurred within previous 5 days (best within 72 hours), refer to ED for best collection
of evidence. Prepare the patient for the examination. Advise patient not to shower, etc. If
longer than 5 days, perform STI testing and treat injuries/wounds as needed.
RATIONALE:
Timely evidence collection is critical for forensic purposes. The ED has the resources for a sexual
assault nurse examiner (SANE) and proper chain of custody. Beyond 5 days, the focus shifts to
medical care including STI prophylaxis, emergency contraception, and follow‑up for
psychological support.
Question 2
What are the three options for emergency contraception?
Correct answer: Plan B (levonorgestrel), Ulipristal acetate (Ella), and the Copper IUD.
RATIONALE:
Emergency contraception prevents pregnancy after unprotected intercourse. Levonorgestrel is
effective up to 72 hours, ulipristal up to 120 hours, and the Copper IUD can be inserted up to 5
days after ovulation. The IUD is the most effective option.
,Question 3
What are the two major categories of cardiac causes of syncope?
Correct answer:
Mechanical/obstructive (e.g., aortic stenosis, hypertrophic cardiomyopathy) and
arrhythmic (more common).
RATIONALE:
Cardiac syncope is the most dangerous form. Arrhythmias (e.g., ventricular tachycardia, heart
block) are the most frequent; mechanical obstruction can reduce cardiac output during exertion.
Both require urgent cardiology evaluation.
Question 4
What are the signs and symptoms of influenza?
Correct answer:
Fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue.
RATIONALE:
Influenza is a viral respiratory illness with sudden onset of systemic symptoms. Fever is usually
high, and myalgias are prominent. Unlike the common cold, influenza tends to cause more
severe constitutional symptoms and can lead to pneumonia, especially in high‑risk groups.
Question 5
What are the three categories of infectious diarrhea?
Correct answer:
Inflammatory, non‑inflammatory, and penetrating gastrointestinal illness.
RATIONALE:
Inflammatory diarrhea involves invasion of the mucosa, producing fever and bloody stools.
Non‑inflammatory is watery and usually self‑limited. Penetrating illness can cause systemic
symptoms and may affect the small intestine, leading to malabsorption.
, Question 6
For whom is the herpes zoster (shingles) vaccine recommended?
Correct answer: Adults ≥50 years of age.
RATIONALE:
The risk of shingles and post‑herpetic neuralgia increases with age. The recombinant zoster
vaccine (Shingrix) is preferred over the live vaccine (Zostavax) and has higher efficacy. Two
doses are given 2‑6 months apart.
Question 7
In which unstable patients with tachycardia is cardioversion used?
Correct answer:
Stable atrial fibrillation, atrial flutter, and monomorphic ventricular tachycardia.
RATIONALE:
Cardioversion is a synchronized electrical shock used to restore normal sinus rhythm in
tachyarrhythmias with a discernible QRS complex. It is indicated in unstable patients or those
who do not respond to medications. Defibrillation is used for pulseless ventricular tachycardia
or ventricular fibrillation.
Question 8
What scale is used to measure severity of head trauma, and what three categories does it
score?
Correct answer:
Glasgow Coma Scale (GCS) – highest score is 15. It scores Eye Opening, Best Motor
Response, and Best Verbal Response.
RATIONALE:
The GCS is a standardized tool to assess level of consciousness. Scores range from 3 to 15. It is
used to guide clinical management and predict outcomes in traumatic brain injury.
