2026-2027 FNP 654 FAMILY CARE PRIMARY 2
MIDTERM EXAM REVIEW ACTUAL AND
COMPLETE EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES A
NEW UPDATED VERSION LATEST 2026-2027
(100% CORRECT VERIFIED ANSWERS) FNP 654
MIDTERM EXAM ALREADY GRADED A+
Question 1
A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to
have symptoms that include asymmetric weakness in the arms difficulty and
walking. The neurologist recognizes these symptoms as characteristic of
involvement of which portion of the nervous system?
A) Upper motor neurons
B) Lower motor neurons
C) Both upper and lower motor neurons
D) Peripheral sensory neurons
Rationale: ALS is characterized by the degeneration of both upper and lower
motor neurons, but the initial presenting symptoms of asymmetric weakness and
,difficulty with ambulation are classic signs of lower motor neuron involvement.
Lower motor neuron findings include weakness, atrophy, and fasciculations,
whereas upper motor neuron findings include spasticity and hyperreflexia .
Question 2
The spouse of a patient newly diagnosed with ALS asks about long-term care.
What will the provider include when teaching the family about this disease?
A) The disease typically responds well to immunosuppressive therapy
B) Preventing malnutrition is a key element in care
C) Most patients survive 10-15 years after diagnosis
D) Physical therapy should be avoided to prevent muscle fatigue
Rationale: Malnutrition is a significant concern in ALS patients due to progressive
dysphagia and muscle wasting. Nutritional support, including feeding tube
placement when indicated, is crucial for maintaining weight and overall health.
ALS is a progressive neurodegenerative disease with average survival of 3-5 years
after diagnosis .
Question 3
Which symptoms may occur with Bell's palsy? Select all that apply.
A) Bilateral facial paralysis
B) Alteration in taste C) Drooling D) Tinnitus
Rationale: Bell's palsy is an acute, unilateral facial nerve paralysis. Symptoms
include drooling, altered taste sensation (dysgeusia), tinnitus or hyperacusis, and
,unilateral facial weakness. Bilateral facial paralysis would suggest a different
etiology, such as Guillain-Barré syndrome or Lyme disease .
Question 4
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 unilateral full
face paralysis on the right side. What is the initial intervention for this patient?
A) Recommend warm compresses and massage
B) Prescribe oral prednisolone
C) Order an MRI of the brain
D) Refer to a neurologist immediately
Rationale: Oral corticosteroids (prednisolone or prednisone) are the first-line
treatment for Bell's palsy when started within 72 hours of symptom onset. This
reduces inflammation of the facial nerve and improves outcomes. Antiviral therapy
may be added but steroids remain the mainstay of treatment .
Question 5
What is recommended to prevent ophthalmic complications in patients with Bell's
palsy?
A) Topical antibiotic ointment
B) Lubricating eye drops
C) Occlusive eye patches
D) Systemic corticosteroids
, Rationale: Lubricating eye drops and artificial tears are recommended to prevent
corneal drying and ulceration in patients with Bell's palsy who have incomplete
eye closure. Eye protection, including taping the eyelid closed at night, may also be
necessary to prevent exposure keratopathy .
Question 6
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?
A) Audiometry testing
B) CT scan of the head
C) The Hallpike-Dix positioning maneuver
D) Electroencephalogram
Rationale: The Hallpike-Dix maneuver is the diagnostic test of choice for benign
paroxysmal positional vertigo (BPPV), the most common cause of recurrent
spinning sensations. A positive test reproduces nystagmus and vertigo with specific
head positioning. This test helps differentiate BPPV from other causes of vertigo .
Question 7
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?
A) Otolaryngologist
B) Cardiologist
MIDTERM EXAM REVIEW ACTUAL AND
COMPLETE EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES A
NEW UPDATED VERSION LATEST 2026-2027
(100% CORRECT VERIFIED ANSWERS) FNP 654
MIDTERM EXAM ALREADY GRADED A+
Question 1
A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to
have symptoms that include asymmetric weakness in the arms difficulty and
walking. The neurologist recognizes these symptoms as characteristic of
involvement of which portion of the nervous system?
A) Upper motor neurons
B) Lower motor neurons
C) Both upper and lower motor neurons
D) Peripheral sensory neurons
Rationale: ALS is characterized by the degeneration of both upper and lower
motor neurons, but the initial presenting symptoms of asymmetric weakness and
,difficulty with ambulation are classic signs of lower motor neuron involvement.
Lower motor neuron findings include weakness, atrophy, and fasciculations,
whereas upper motor neuron findings include spasticity and hyperreflexia .
Question 2
The spouse of a patient newly diagnosed with ALS asks about long-term care.
What will the provider include when teaching the family about this disease?
A) The disease typically responds well to immunosuppressive therapy
B) Preventing malnutrition is a key element in care
C) Most patients survive 10-15 years after diagnosis
D) Physical therapy should be avoided to prevent muscle fatigue
Rationale: Malnutrition is a significant concern in ALS patients due to progressive
dysphagia and muscle wasting. Nutritional support, including feeding tube
placement when indicated, is crucial for maintaining weight and overall health.
ALS is a progressive neurodegenerative disease with average survival of 3-5 years
after diagnosis .
Question 3
Which symptoms may occur with Bell's palsy? Select all that apply.
A) Bilateral facial paralysis
B) Alteration in taste C) Drooling D) Tinnitus
Rationale: Bell's palsy is an acute, unilateral facial nerve paralysis. Symptoms
include drooling, altered taste sensation (dysgeusia), tinnitus or hyperacusis, and
,unilateral facial weakness. Bilateral facial paralysis would suggest a different
etiology, such as Guillain-Barré syndrome or Lyme disease .
Question 4
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 unilateral full
face paralysis on the right side. What is the initial intervention for this patient?
A) Recommend warm compresses and massage
B) Prescribe oral prednisolone
C) Order an MRI of the brain
D) Refer to a neurologist immediately
Rationale: Oral corticosteroids (prednisolone or prednisone) are the first-line
treatment for Bell's palsy when started within 72 hours of symptom onset. This
reduces inflammation of the facial nerve and improves outcomes. Antiviral therapy
may be added but steroids remain the mainstay of treatment .
Question 5
What is recommended to prevent ophthalmic complications in patients with Bell's
palsy?
A) Topical antibiotic ointment
B) Lubricating eye drops
C) Occlusive eye patches
D) Systemic corticosteroids
, Rationale: Lubricating eye drops and artificial tears are recommended to prevent
corneal drying and ulceration in patients with Bell's palsy who have incomplete
eye closure. Eye protection, including taping the eyelid closed at night, may also be
necessary to prevent exposure keratopathy .
Question 6
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?
A) Audiometry testing
B) CT scan of the head
C) The Hallpike-Dix positioning maneuver
D) Electroencephalogram
Rationale: The Hallpike-Dix maneuver is the diagnostic test of choice for benign
paroxysmal positional vertigo (BPPV), the most common cause of recurrent
spinning sensations. A positive test reproduces nystagmus and vertigo with specific
head positioning. This test helps differentiate BPPV from other causes of vertigo .
Question 7
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?
A) Otolaryngologist
B) Cardiologist
