NURS 8024 FINAL EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NURS 8024 FINAL EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 who is the certifying body we take the WHNP boards through? - Answers NCC (National Certification Corporation) this is a nurse who has graduate level of education; passed national certification, built on competencies of an RN, is educationally prepared to take on the responsibility/accountability of patient issues - Answers Advanced Practice Nurse (APRN) What are the four APRN roles? - Answers NP CNM CNS CRNA The national organization of nurse practitioner faculties (NONPF) describes NINE core competencies...what are they - Answers scientific foundation leadership quality practice inquiry technology/information literacy policy health delivery system ethics independent practice 2 national organizations that provide guidelines for WHNP practice and education? - Answers american association of colleges of nursing (AACN) national organization of NP faculties (NONPF) Process for certification maintenance for an NP - Answers -cert is valid for 3 years -complete continuing competency assessment at the beginning of your maintenance cycle -continuing education earned is based on your education plan after the assessment is completed maintain current/active, unencumbered licensure, update and upload licensure main provisions of patient protection and affordable care act? - Answers increase access to insurance decrease cost consumer protection wellness/prevention increase quality of healthcare expand workforce what is the scope of practice of a WHNP - Answers providing gynecologic, sexual, obstetric, and reproductive care, mgmt, family planning, STI dx/tx, menopause mgmt, postmenopausal care, and primary care to women. Who Governs the scope of practice of WHNP? - Answers **established by the nurse practice act in the STATE which they are licensed/practice in what is prescriptive authority? - Answers The ability and extent of NP's ability to prescribe medication; is dependent on state nurse practice act what are the 4 levels of management of care? - Answers independent consultation referral collaboration example of independent level management of care - Answers functioning as a lone provider that manages previously and undiagnosed patients. example of consultation level management of care - Answers request for direction or help on a dx/tx plan from another provider example of referral level management of care - Answers another provider accepting the ongoing treatment/care for a problem example of collaboration level management of care - Answers joint communication and decision-making between healthcare professionals that are working towards mutual goals of patient care this is the process by which an NP will receive the authority of bill insurance companies for the services they provide; this is usually completed by the practice manager. Involves a provider obtaining authorization to practice - Answers credentialing/privileging process these are considered "practice guidelines"; the "how to" of a discipline or specialty. they clarify scope and authority r/t a specific activity by defining who can do what activity, with what level of supervision, and when (stated at the state board/institution level) - Answers standards of practice provision of services in a manner consistent with care as a another professional with similar training and experience faced with a similar situation would provide; sets minimum criteria for job proficiency (stated by medicare, joint commission) - Answers standards of care independence; capacity for making decisions, judgement, knowledge, and self-determination. ex: clinical decision making - Answers autonomy Obligation to promote patient's well being, or an act of kindness/charity. ex: holding a dying patients hand; "do good" - Answers Beneficence the obligation not to harm or cause injury ex: stopping a medication that is causing harmful SE's - Answers nonmalifience remaining TRUTHFUL w/ the patients regardless of any circumstances ex: telling the patient the truth, never lying, even if it may cause distress - Answers veracity moral and ethics of a provider; keeping your promise ex: telling a patient you will come back and check on their pain, and actually doing so - Answers fidelity unity and mutuality; FAIR distribution of resources and care in healthcare ex: providing the same treatment options to two different patients - Answers justice integration of clinical expertise with the best available clinical evidence from research; is the "conscientious, explicit, and judicious use of theory-derived, research-based information in making decisions about care delivery to patients and in consideration of individual needs and preferences. - Answers evidence-based practice What does HIPAA stand for? - Answers Health Insurance Portability and Accountability Act (1996) what is the health insurance portability and accountability act? - Answers federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge The process of drug absorption, distribution, metabolism, and excretion; the MOVEMENT of drugs within the body, what the BODY DOES to a drug - Answers pharmacokinetics study of drug concentration and the patients response; the study of a drug's EFFECT, including the duration and magnitude of the response in relation to the drug dosage, what the DRUG DOES to the body - Answers pharmacodynamics study of how different genes in the full genome determine drug behavior; identifies genes involved in drug metabolism and drug response - Answers pharmacogenomics what are the four factors that affect pharmacokinetics? - Answers distribution absorption metabolism excretion (DAME) process by which a drug becomes available to body fluids/tissues? - Answers distribution The movement of drug particles from the GI tract to body fluids by passive absorption, active absorption, or pinocytosis. - Answers absorption change of a drug (primarily in the liver) by CYP450 enzymes, into metabolites that may be active or inactive; alters a drug so it can be eliminated. - Answers metabolism removal of a drug from the body; primarily occurs in the kidneys, but can also occur through the skin, lungs, bile, sweat, breast milk, or feces - Answers excretion use of prescribing of a drug for conditions other than what it has been approved for by the FDA... - Answers off-label use warning that appears on the insert for a medication that notes harm with the use of the drug; mandated by FDA - Answers black-box warning off label drug uses in pregnancy. - Answers Unisom (morning sickness), Methotrexate (ectopic) black-box warning in pregnancy - Answers isotretinoin (accutane), ACE/ARB's Drugs with NO currently accepted medical use and a high potential for abuse - Answers schedule I (heroin) Drugs with a high potential to cause psychological or physical dependence and abuse are called ____. however some do have medical use. - Answers schedule II (methadone/morphine) drugs with a moderate to low potential for abuse and physical and psychological dependence - Answers schedule III (codeine) Drugs with low potential for abuse and low risk of dependence - Answers schedule IV (phenobarbital) drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. - Answers schedule V (cough preparations; Robitussin) how do you report an adverse drug reaction or event? - Answers call FDA directly, use the FDA adverse reporting system (FAERS)- they collect reports on ADE's, ADR's, quality issues, usage errors, and therapeutic failures. NP's can submit reports through the MedWatch website. what are the 4 components of drug distribution in a pregnant woman? - Answers distribution absorption metabolism excretion (DAME) what happens to plasma volumes in a pregnant woman? - Answers they INCREASE (hemodilution) what happens to plasma proteins in a pregnant woman? - Answers they DECREASE what happens to total body water in a pregnant woman? - Answers it INCREASES what happens to total body fat in a pregnant woman? - Answers it INCREASES most drugs move from mom, across the placenta by the following mechanism.... - Answers diffusion (simple/passive) What drugs do NOT cross the placenta? - Answers Heparin Insulin Glyburide Oxytocin there is a change in the absorption of lipophilic drugs in pregnancy; t or f - Answers false hepatic metabolism of drugs in pregnancy increases AND decreases; t or f - Answers true! the only TWO things that *decrease* in pregnancy and affect drug pharmacokinetics... - Answers intestinal motility/emptying plasma proteins the things that *increase* in pregnancy and affect drug pharmacokinetics.... - Answers ventilation 3 output blood flow to skin gastric pH intestinal transport time plasma volume total body water body fat uterine blood flow renal blood flow GFR increased ventilation in pregnancy results in an increase or decrease in drug uptake - Answers increase increased blood flow to the skin in pregnancy results in an increase or decrease in drug absorption - Answers increase (TD, IN, IV, epidural, SQ) increase in plasma volume in pregnancy results in an increase or decrease in plasma drug concentration... - Answers decrease (meaning the pt may need a higher dose of medication to have effects) increase in GFR and renal blood flow in pregnancy results in an increase or decrease in drug elimination... - Answers increase (may need to increase dose b/c of this) What is teratology? - Answers The study of birth defects / abnormal development What is a teratogen? - Answers an agent or factor that causes malformation of an embryo what are examples of teratogens? - Answers ETOH drugs lead mercery thalidomide DES accutane Vit A tetracyclines ACE/ARB misoprostol FDA Pregnancy Categories - Answers A, B, C, D, X Category A drugs and pregnancy - Answers Studies indicate no risk to the human fetus. Safe for mother and baby (ex: MV/ synthroid) Category B drugs (pregnancy) - Answers Studies indicate no risk to an animal fetus; information for humans is not available (ex: Tylenol, Amoxicillin, Metformin) Category C drugs and pregnancy - Answers Adverse effects reported in the animal fetus; information for humans not available- benefits MAY outweigh risks (ex: oxytocin, Zoloft) Category D drugs and pregnancy - Answers Possible fetal risk in humans has been reported- benefits MAY outweigh risks (ex: NSAID's, losartan, lisinopril, paxil) Category X pregnancy - Answers Animal or human studies have shown fetal abnormalities or toxicity, and the RISK outweighs the benefits (ex: ergotamine, atorvastatin, methotrexate, thalidomide, accutane) what is the "all or nothing" phenomenon in pregnancy? - Answers exposure to something in utero either causes an effect (all/death), or does nothing at all. occurs before organogenesis/embryonic period...exposure to a teratogen at this point will either kill the embryo or it will survive. if it survives, no adverse effects occur. When does organogenesis occur? - Answers week 3-8 (embryonic period) health care services by clinicians who are accountable for addressing a large majority of personal health care needs; developing a sustained partnership with patients, and practicing in the context of family and community - Answers primary care leading cause of death ages 11-24 - Answers unintentional injury leading cause of death ages 25-45 - Answers unintentional injury leading cause of death ages 45-65 - Answers cancer/malignant neoplasm leading cause of death ages 65 years and beyond - Answers heart disease USPSTF Grade A recommendations. - Answers The USPSTF recommends the service. There is high certainty that the net benefit is substantial USPSTF Grade B Recommendations. - Answers The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial. USPSTF Grade C recommendations - Answers The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small. USPSTF grade D recommendations - Answers The USPSTF recommends against the service. There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits. USPSTF Grade I Recommendations - Answers The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined. this is the awareness and respect for other cultures; provide non-biased, non-judgmental care, recognize that people from other cultures may have different beliefs/practices. this is the skill of learning, accepting, and appreciating cultural differences and similarities between groups, and being able to act on that understanding. - Answers cultural competence health history is (CC, HPI, ROS- +/-)subjective/objective... - Answers subjective The physical exam is subjective/objective... - Answers objective Diagnostic testing is subjective/objective... - Answers objective screening tests are subjective/objective... - Answers objective immunizations are subjective/objective... - Answers objective What does the CAGE questionnaire stand for? - Answers Cut down (Ever feel you need to cut down on ___) Annoyed with others' comments about your drinking? Guilty (about your use) Eye opener (need to use in AM to function) What is the TACE questionaire? - Answers Tolerance (how many drinks to feel drunk) Annoyed (people making comments about your drinking) Cut down (on drinking) Eye opener (need to use in AM to function) what is the best questionnaire to use for ETOH use in pregnancy? - Answers TACE (score of 2 or = @ risk) what are the USPSTF's 5 "A's" for prevention, screening, and mgmt of smoking cessation? - Answers Ask Advise Assess Assist Arrange what are the recommended adult immunizations per the CDC - Answers influenza tdap MMR varicella zoster HPV pneumococcal (high risk- Hep A, Hep B, Meningococcal, Influenza Hib) (college students- meningococcal) USPSTF screening recommendation for diabetes (grade B)? - Answers adults aged 35 to 70 years who have overweight or obesity (FBG, GTT, A1C) USPSTF screening recommendation for HIV in PREGNANCY (grade A)? - Answers The USPSTF recommends that clinicians screen for HIV infection in **ALL** pregnant persons, including those who present in labor or at delivery whose HIV status is unknown. USPSTF screening recommendation for HIV in general population (grade A)? - Answers adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk of infection should also be screened. USPSTF screening recommendation for intimate partner violence in women of reproductive age (grade B)? - Answers The USPSTF recommends that clinicians screen for intimate partner violence (IPV) in women of reproductive age and provide or refer women who screen positive to ongoing support services. USPSTF screening recommendation for intimate partner violence in older or vulnerable adults (grade I)? - Answers The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for abuse and neglect in all older or vulnerable adults. what are the screening tools to use for IPV? - Answers HITS -hurt -insult -threaten -scream USPSTF screening recommendations for lipid disorders (grade B)? - Answers Adults aged 40 to 75 years with no history of CVD, 1 or more CVD risk factors, and a calculated 10-year CVD event risk of 10% or greater use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: 1) they are aged 40 to 75 years; 2) they have 1 or more CVD risk factors (ie, dyslipidemia, diabetes, hypertension, or smoking); and 3) they have a calculated 10-year risk of a cardiovascular event of 10% or greater. Identification of dyslipidemia and calculation of 10-year CVD event risk requires ***universal lipids screening in adults aged 40 to 75 years*** USPSTF screening recommendations for substance abuse (grade B)? - Answers Tasking questions about unhealthy drug use in **adults age 18 years or older** USPSTF screening recommendations for suicide risk (grade I)? - Answers General Adult Population: The USPSTF concludes that the evidence is insufficient to recommend for or against routine screening by primary care clinicians to detect suicide risk in the general population. USPSTF screening recommendations for depression in General adult population, including pregnant and postpartum women (grade B)? - Answers The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. what screening tool can be used for depression? - Answers PHQ what screening tool can be used for postpartum depression? - Answers edinburgh USPSTF screening recommendations for thyroid disease in Nonpregnant, asymptomatic adults (grade I)? - Answers The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for thyroid dysfunction in nonpregnant, asymptomatic adults USPSTF screening recommendations for breast cancer screening (grade B)? - Answers biennial (every other year) screening mammography for women aged 50 to 74 years What is the USPSTF's recommendation regarding breast cancer screening for women aged 40-49 (grade I)? - Answers The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years. what is the USPSTF's recommendation for cervical cancer screening in women aged 21-65 (grade A)? - Answers every 3 years with cervical cytology alone in women aged 21 to 29 years every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus testing alone, or every 5 years with HPV testing in combination with cytology in women aged 30 to 65 years what is the USPSTF's recommendation for cervical cancer screening in women 65 (grade D)? - Answers recommends AGAINST screening for cervical cancer in women older than 65 years who have had adequate prior screening and are not otherwise at high risk for cervical cancer. what is the USPSTF's recommendation for cervical cancer screening in women younger than 21 (grade D)? - Answers recommends against it what is the USPSTF's recommendation for cervical cancer screening in women who have had a hysterectomy (grade D)? - Answers recommends AGAINST screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of a high-grade precancerous lesion ([CIN] grade 2 or 3) or cervical cancer. USPSTF's screening recommendations for colorectal cancer screening in age 50-75 (grade A)? - Answers recommends screening for colorectal cancer in ALL adults aged 50 to 75 years. USPSTF's screening recommendations for colorectal cancer screening in age 45-49 (grade B)? - Answers recommends screening for colorectal cancer in adults aged 45 to 49 years. (basically they recommend screening everyone age 45-75) USPSTF's screening recommendations for colorectal cancer screening in age 75 (grade C)? - Answers USPSTF's screening recommendations for colorectal cancer screening in age (evaluate individual risk) JNC 8 criteria for HTN diagnosis in those age 60+ withOUT DM/CKD... - Answers 150/90 (initiate therapy) JNC 8 criteria for HTN diagnosis in those 60 without DM/CKD... - Answers 140/90 (initiate therapy) JNC 8 criteria for HTN diagnosis in those WITH DM/CKD (all ages)... - Answers 140/90 in the black population w/ HTN but with no DM/CKD...what med should you start with - Answers thiazide or CCB in the NON-black population w/ HTN but with no DM/CKD...what med should you start with - Answers thiazide, ACEI, ARB, or CCB in black and non-black population w/ HTN + DM/CKD...what med should you start with - Answers ACEI or ARB what are the parameters to diagnosis pre-htn? - Answers systolic BP 120 to 139 mm Hg diastolic BP 80 to 89 mm Hg based on ≥2 properly measured, seated BP readings on each of 2 or more office visits. first line management for a woman diagnosed with primary HTN? - Answers lifestyle modification first and foremost • Smoking Cessation • Control blood glucose and lipids • Diet Eat healthy (i.e., DASH diet) weight loss Moderate alcohol consumption Reduce sodium intake no more than 2400 mg/day • Physical activity Moderate-to-vigorous activity 3-4 days/wk What does the DASH diet stand for? - Answers Dietary Approach to Stop Hypertension what is the first line MEDICATION for a woman diagnosed with primary HTN who is NOT black and does not have DM or CKD? - Answers Initiate thiazide, ACEI, ARB, or CCB, alone or in combo what is the first line MEDICATION for a woman diagnosed with primary HTN who IS black and does not have DM or CKD? - Answers Initiate thiazide or CCB, alone or combo headache that is: -more common in women -caused by VASCULAR CHANGES (regional hypoperfusion) -triggers=hormones, stress, lighting, noise -has a prodrome, AURA, H/A, postdrome - Answers migraine w/ aura is a migraine with aura bilateral or unilateral? - Answers unilateral (one sided) what is the treatment for migraine w/ aura? - Answers NSAIDS Ergotamine (teratogenic) Triptans (watch w/ SSRI's) Antiemetics Dark room in what type of headache is combined hormonal contraception contraindicated in? - Answers migraine WITH aura (as migraines w/ aura are often d/t hormonal issues, estrogen containing BC can increase stroke risk...already have regional hypoperfusion...increases the risk for ischemic stroke) this type of headache is: often d/t menstrual cycle in childbearing aged women DOES NOT CAUSE vascular changes OR hypoperfusion lasts 4-72 hours is UNIlateral DOES NOT have aura occuring before onset - Answers migraine W/OUT aura migraines are or aren't triggered by physical activity... - Answers ARE* this type of headache is: more common in MEN r/t release of histamine/serotonin - Answers cluster headaches which headache causes horner-like syndrome (hallmark sign of this type of HA: ptosis/miosis on affected side) - Answers cluster which headache often exhibits tearing of the eyes, stuffy nose on same side as headache... - Answers cluster this headache occurs 1-3 hours after falling asleep, pt is often restless because of it.. - Answers cluster What is Horner syndrome characterized by? - Answers bradycardia, flush/pallor, warm skin there is no cure cluster headaches; refer to specialists...some options for relief include: - Answers O2, triptans, local anesthesia, octreotide, DHE what is the most common type of headache? women men - Answers Tension headache this type of headache has a CNS and PNS mechanism. CNS- hypersensitivity of trigeminal nerve PNS- contraction of jaw/neck muscles - Answers tension what is the #1 risk factor for tension headache? - Answers STRESS how do most people describe a tension headache? - Answers "like a band around my head" are tension headaches triggered by physical activity? - Answers NO tension headaches are unilateral or bilateral? - Answers bilateral- mainly frontal or occipital area and/or cervical spine what is the 1st line treatment for tension headaches? - Answers NDAID's, tylenol, excedrin, naproxen What is CVAT and what are we assessing when we do this? - Answers the CV angle is the angle formed by the 12th rib and spine. in the event of kidney infection/inflammation, this maneuver elicits tenderness/pain how do we perform CVAT - Answers placing a hand over the patients flank, and hit your hand with the fist of the other hand...assess for pain what are the most common symptoms of cystitis (lower UTI)? - Answers dysuria malodorous urine frequency/urgency suprapubic pain/pressure what are the most common symptoms of pyelonephritis (upper UTI)? - Answers same as cystitis but with N/V, FEVER, CVAT* what is the appropriate testing for a UTI? - Answers urinalysis (looking for leuks/nitrites) then UC to determine causative organisms/and verify tx regimen Treatment for UTI in non-pregnant patient - Answers 1* Nitrofurantoin (macrobid) 100mg BID x5 days 2- Fosfomycin (monurol) 3g x1 3- Bactrim (TMP/SMX) 160/800 BID x3 days (IF resistance is 20%) Treatment for UTI in a PREGNANT patient - Answers PCN (amoxicillin) - 500mg Q8H for 5-7 days OR 875mg Q12H for 5-7 days Augmentin (amoxicillin-clavunate) Cephalosporin (Keflex/Cephalexin)- 250-500mg Q6H for 5-7 days what medication for UTI is avoided at end of pregnancy and in patients with glucose-6-phosphate dehydrogenase deficiency d/t risk of hemolytic anemia in the newborn? - Answers nitrofurantoin what medication for UTI is avoided in the FIRST and THIRD trimester b/c it is a folate antagonist (1st trimester) and in those with g6pd (third trimester; hemolytic anemia) and in those with sulfa allergy? - Answers Bactrim (TMP/SMX) This type of diabetes typically begins in childhood, and is d/t beta cell destruction...there is a genetic component (especially w/ 1st degree relatives)...requires insulin - Answers type I DM this type of diabetes is d/t insulin deficiency/secretory effect & increased hepatic glucose production...lifestyle modification (exercise/diet), oral anti-DM's, sometimes insulin - Answers Type II DM what is the prevalence of type I DM in the US - Answers 10% of those diagnosed w/ DM have type I what is the prevalence of type II DM in the US - Answers 1 in 10 Americans; 14 million cases risk factors for type II DM include: - Answers obesity sedentary lifestyle family h/o certain races (native Americans, Hispanics, blacks, Asians) high cholesterol what is the prevalence of obesity in the US - Answers 68.8% of the US population