lOMoAR cPSD| 57629747
Clinical Proficiency (Herzing University)
, lOMoAR cPSD| 57629747
Clinical Proficiency Exam: APEA Study
Test 1: 20 Sample Questions
1. The family nurse practitioner asks a patient to perform rapid, alternating movements of the
hands to evaluate:
a. cerebellar functioning.
b. cognitive functioning.
c. reflex arc functioning.
d. stereognostic functioning.
2. After determining that a two-and-half-year-old patient has a lead level of 16 mcg/dL, the family
nurse practitioner:
A. advises the parent to avoid giving the patient bottles of whole milk.
B. consults with a physical therapist for muscle strengthening.
C. orders an increase of iron supplements to 6 mg/kg per day divided in two doses.
D. repeats a blood test within one week to one month.
Note: A blood lead level (BLL) of 16 mcg/dL in a two-and-half-year-old is considered high (above the
3.5-5 mcg/dL reference range) and requires urgent follow-up, typically repeating the blood test within
one week to one month (often sooner for higher levels), to confirm the level, assess the trend, and
monitor for acute toxicity or rapidly rising levels.
CDC recommends that children with BLLs of 3.5 µg/dL and higher receive routine assessment of
nutritional and developmental milestones, environmental exposure history to identify potential
sources of lead exposure, nutritional counseling related to calcium and iron intake, and follow-up
blood lead level testing at recommended intervals based on the child's age. CDC provides a
summary of recommended actions based on blood lead level.
Interventions for a child with high lead levels focus on immediate elimination of the lead source,
dietary improvements (high calcium, iron, Vitamin C), and medical management. Key actions
include cleaning surfaces to reduce dust, using cold filtered water, and potential chelation therapy
for levels.Early educational, developmental, and nutritional support is critical to manage potential
long-term effects.
Chelation therapy is a medical procedure that uses agents such as EDTA to bind and remove
heavy metals (lead, mercury, iron, arsenic) from the body via urine, primarily for the treatment of
acute metal poisoning. While used for iron overload or lead toxicity, it is not FDA-approved for heart
disease or other conditions. Common side effects include burning at the IV site, fever, or headache,
with risks of kidney damage or low calcium. The treatment can be costly, often involving 20-40
sessions.
Key Details About Chelation Therapy
● How it Works: Chelation agents (most commonly Calcium EDTA) are injected into the
bloodstream, where they "grab" or bind to heavy metals and minerals, forming a compound
that is easily excreted by the body through urine or stool.
● Medical Uses: It is a proven, FDA-approved treatment for:
○ Heavy Metal Poisoning: Lead, mercury, arsenic, and iron toxicity.
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, lOMoAR cPSD| 57629747
○ Iron Overload: Conditions like thalassemia that require frequent blood transfusions. ○
Wilson's Disease: A condition causing copper to accumulate.
Thalassemia is an inherited blood disorder caused by genetic mutations that reduce or eliminate the
production of hemoglobin, leading to mild to severe anemia.
3. A 38-year-old patient who is Vietnamese tells the family nurse practitioner that their parent died in
their 40s from liver cancer. The nurse practitioner assesses that the patient is at risk for: A.
hepatitis B.
B. malaria.
C. tularemia.
D. Tyrosinemia.
Based on the family history of liver cancer and the patient's Vietnamese ethnicity, the nurse
practitioner assesses that the patient is at risk for hepatitis B. Chronic hepatitis B infection is a
leading cause of liver cancer in Asian populations, particularly among individuals from high-
prevalence areas like Vietnam.
Hepatitis B is a viral infection that damages your liver. You can get it if you’re exposed to infected
bodily fluids. The acute form of the virus often goes away without treatment. But chronic hepatitis B
is an incurable illness. Treatment is medication to reduce the risk that the virus will spread or cause
complications.
Downloaded by Collins Mwaniki ()
Clinical Proficiency (Herzing University)
, lOMoAR cPSD| 57629747
Clinical Proficiency Exam: APEA Study
Test 1: 20 Sample Questions
1. The family nurse practitioner asks a patient to perform rapid, alternating movements of the
hands to evaluate:
a. cerebellar functioning.
b. cognitive functioning.
c. reflex arc functioning.
d. stereognostic functioning.
2. After determining that a two-and-half-year-old patient has a lead level of 16 mcg/dL, the family
nurse practitioner:
A. advises the parent to avoid giving the patient bottles of whole milk.
B. consults with a physical therapist for muscle strengthening.
C. orders an increase of iron supplements to 6 mg/kg per day divided in two doses.
D. repeats a blood test within one week to one month.
Note: A blood lead level (BLL) of 16 mcg/dL in a two-and-half-year-old is considered high (above the
3.5-5 mcg/dL reference range) and requires urgent follow-up, typically repeating the blood test within
one week to one month (often sooner for higher levels), to confirm the level, assess the trend, and
monitor for acute toxicity or rapidly rising levels.
CDC recommends that children with BLLs of 3.5 µg/dL and higher receive routine assessment of
nutritional and developmental milestones, environmental exposure history to identify potential
sources of lead exposure, nutritional counseling related to calcium and iron intake, and follow-up
blood lead level testing at recommended intervals based on the child's age. CDC provides a
summary of recommended actions based on blood lead level.
Interventions for a child with high lead levels focus on immediate elimination of the lead source,
dietary improvements (high calcium, iron, Vitamin C), and medical management. Key actions
include cleaning surfaces to reduce dust, using cold filtered water, and potential chelation therapy
for levels.Early educational, developmental, and nutritional support is critical to manage potential
long-term effects.
Chelation therapy is a medical procedure that uses agents such as EDTA to bind and remove
heavy metals (lead, mercury, iron, arsenic) from the body via urine, primarily for the treatment of
acute metal poisoning. While used for iron overload or lead toxicity, it is not FDA-approved for heart
disease or other conditions. Common side effects include burning at the IV site, fever, or headache,
with risks of kidney damage or low calcium. The treatment can be costly, often involving 20-40
sessions.
Key Details About Chelation Therapy
● How it Works: Chelation agents (most commonly Calcium EDTA) are injected into the
bloodstream, where they "grab" or bind to heavy metals and minerals, forming a compound
that is easily excreted by the body through urine or stool.
● Medical Uses: It is a proven, FDA-approved treatment for:
○ Heavy Metal Poisoning: Lead, mercury, arsenic, and iron toxicity.
Downloaded by Collins Mwaniki ()
, lOMoAR cPSD| 57629747
○ Iron Overload: Conditions like thalassemia that require frequent blood transfusions. ○
Wilson's Disease: A condition causing copper to accumulate.
Thalassemia is an inherited blood disorder caused by genetic mutations that reduce or eliminate the
production of hemoglobin, leading to mild to severe anemia.
3. A 38-year-old patient who is Vietnamese tells the family nurse practitioner that their parent died in
their 40s from liver cancer. The nurse practitioner assesses that the patient is at risk for: A.
hepatitis B.
B. malaria.
C. tularemia.
D. Tyrosinemia.
Based on the family history of liver cancer and the patient's Vietnamese ethnicity, the nurse
practitioner assesses that the patient is at risk for hepatitis B. Chronic hepatitis B infection is a
leading cause of liver cancer in Asian populations, particularly among individuals from high-
prevalence areas like Vietnam.
Hepatitis B is a viral infection that damages your liver. You can get it if you’re exposed to infected
bodily fluids. The acute form of the virus often goes away without treatment. But chronic hepatitis B
is an incurable illness. Treatment is medication to reduce the risk that the virus will spread or cause
complications.
Downloaded by Collins Mwaniki ()
