FNP 654 Final Exam Questions and Correct Answers
Graded Highest 100% A++
A 12-year-old child is brought to the clinic with joint pain, a 3-week history of low-grade fever,
and a facial rash. The primary care nurse practitioner palpates an enlarged liver 2 cm below the
subcostal margin along with diffuse lymphadenopathy. An ANA test is positive. Which test may
be ordered to confirm a diagnosis of SLE? - CORRECT ANSWER ✔✔ -Anti-double-strand
DNA antibodies
A 13-year-old child has exhibited symptoms of mild depression for several weeks. The parent
reports feeling relieved that the symptoms have passed but concerned that the child now seems to
have boundless energy and an inability to sit still. What will the primary care nurse practitioner
do? - CORRECT ANSWER ✔✔ -Refer the child to a child psychiatrist for evaluation of bipolar
disorder.
A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is
negative. The adolescent's body weight is at 82% of expected for height and age. The mother
reports that her daughter often throws up and refuses to eat most foods. Which condition does the
primary care nurse practitioner suspect? - CORRECT ANSWER ✔✔ -Anorexia nervosa
A 16-year-old female has primary amenorrhea. A pregnancy test is negative. Further testing
reveals a normal TSH and an elevated prolactin level. Which test will the provider order next? -
CORRECT ANSWER ✔✔ -Magnetic resonance imaging
A 16-year-old patient with primary dysmenorrhea has taken NSAIDs and COX-2 inhibitors
without getting relief from symptoms. What will the provider suggest? - CORRECT ANSWER
✔✔ -A combined oral contraceptive
,A 16-year-old sexually active female has symptoms of PID with fever. Cultures are pending. For
outpatient treatment, what will the provider order? - CORRECT ANSWER ✔✔ -Rocephin,
doxycycline, and metronidazole
A 17-year-old patient has undergone surgical incision and drainage of a Bartholin's cyst with
insertion of a drain. What is an important aspect of care for this patient? - CORRECT ANSWER
✔✔ -Weekly follow-up monitoring
A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine
dipstick during a well patient exam. What type of urinary tract infection does this represent? -
CORRECT ANSWER ✔✔ -Complicated
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
A 35-year-old woman without a previous history of dysmenorrhea reports lower pelvic pain and
irregular bleeding between periods. What is the initial action in managing this patient? -
CORRECT ANSWER ✔✔ -Performing an abdominal, pelvic, and rectovaginal examination
A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL
above normal without signs of nephrolithiasis. What is the recommended treatment for this
patient? - CORRECT ANSWER ✔✔ -Annual monitoring of calcium, creatinine, and bone
density
,A 45-year-old woman has gone 120 days without a menstrual period. A pregnancy test is
negative. What will the provider do, based on this symptom? - CORRECT ANSWER ✔✔ -
Evaluate for various causes of amenorrhea
A 50-year-old man reports having erectile dysfunction. What is an important response by the
provider when developing a plan of care for this patient? - CORRECT ANSWER ✔✔ -
Evaluating the patient for cardiovascular disease
A 60-year-old female patient has recently lost weight and a physical examination reveals a
beefy-red, sore tongue, with no neurological findings. Based on these clinical findings, what will
the provider anticipate finding in the laboratory data? - CORRECT ANSWER ✔✔ -Low
hemoglobin and elevated MCV
A 60-year-old patient reports new onset of bilateral shoulder pain with morning stiffness lasting
approximately one hour. Which will be NOT be included in initial diagnostic testing for this
patient? - CORRECT ANSWER ✔✔ -Serum Calcitonin
A 67-year-old female patient reports vulvar pruritus and dyspareunia. The provider notes white
papules on the vulva with thinning of the epithelium. What condition does the provider suspect?
- CORRECT ANSWER ✔✔ -Lichen sclerosis
A 69-year-old patient with cancer is reluctant to take an opioid agonist medication because of the
side effects. What will the primary care provider recommend? - CORRECT ANSWER ✔✔ -
Taking a stool softener with the opioid
, A child has a fever and arthralgia. The primary care nurse practitioner learns that the child had a
sore throat 3 weeks prior and auscultates a murmur in the clinic. Which test will the nurse
practitioner order? - CORRECT ANSWER ✔✔ -ASO Titer
A child has a high fever, bilateral conjunctivitis, and a desquamating rash and is presumed to
have a vasculitic disease. What is the likely treatment for this child? - CORRECT ANSWER ✔✔
-Aspirin and Intravenous immunoglobulin
A child has plaques on the extensor surfaces of both elbows and on the face with minimal scaling
and pruritis. What is the likely cause of these lesions? - CORRECT ANSWER ✔✔ -Psoriasis
A child has vesiculopustular lesions around the nose and mouth with areas of honey-colored
crusts. The provider notes a few similar lesions on the child's hands and legs. Which treatment is
appropriate for this child? - CORRECT ANSWER ✔✔ -Amoxicillin-clavulanate
A child is brought to a clinic with a sudden onset of rash after taking an antibiotic for 2 days. The
provider notes all over wheals with pruritis, which the parent reports seem to come and go.
Which action is correct? - CORRECT ANSWER ✔✔ -Admit the child to the hospital for
treatment and observation
A child who has atopic dermatitis has recurrent secondary bacterial skin infections. What will the
provider recommend to help prevent these infections? - CORRECT ANSWER ✔✔ -Bleach
baths twice weekly
A complete blood count on a 12-month-old infant reveals microcytic, hypochromic anemia with
a hemoglobin of 9.5 g/dL. The infar has mild pallor with no hepatosplenomegaly. The family
nurse practitioner suspects: - CORRECT ANSWER ✔✔ -Iron deficiency anemia
Graded Highest 100% A++
A 12-year-old child is brought to the clinic with joint pain, a 3-week history of low-grade fever,
and a facial rash. The primary care nurse practitioner palpates an enlarged liver 2 cm below the
subcostal margin along with diffuse lymphadenopathy. An ANA test is positive. Which test may
be ordered to confirm a diagnosis of SLE? - CORRECT ANSWER ✔✔ -Anti-double-strand
DNA antibodies
A 13-year-old child has exhibited symptoms of mild depression for several weeks. The parent
reports feeling relieved that the symptoms have passed but concerned that the child now seems to
have boundless energy and an inability to sit still. What will the primary care nurse practitioner
do? - CORRECT ANSWER ✔✔ -Refer the child to a child psychiatrist for evaluation of bipolar
disorder.
A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is
negative. The adolescent's body weight is at 82% of expected for height and age. The mother
reports that her daughter often throws up and refuses to eat most foods. Which condition does the
primary care nurse practitioner suspect? - CORRECT ANSWER ✔✔ -Anorexia nervosa
A 16-year-old female has primary amenorrhea. A pregnancy test is negative. Further testing
reveals a normal TSH and an elevated prolactin level. Which test will the provider order next? -
CORRECT ANSWER ✔✔ -Magnetic resonance imaging
A 16-year-old patient with primary dysmenorrhea has taken NSAIDs and COX-2 inhibitors
without getting relief from symptoms. What will the provider suggest? - CORRECT ANSWER
✔✔ -A combined oral contraceptive
,A 16-year-old sexually active female has symptoms of PID with fever. Cultures are pending. For
outpatient treatment, what will the provider order? - CORRECT ANSWER ✔✔ -Rocephin,
doxycycline, and metronidazole
A 17-year-old patient has undergone surgical incision and drainage of a Bartholin's cyst with
insertion of a drain. What is an important aspect of care for this patient? - CORRECT ANSWER
✔✔ -Weekly follow-up monitoring
A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine
dipstick during a well patient exam. What type of urinary tract infection does this represent? -
CORRECT ANSWER ✔✔ -Complicated
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
A 35-year-old woman without a previous history of dysmenorrhea reports lower pelvic pain and
irregular bleeding between periods. What is the initial action in managing this patient? -
CORRECT ANSWER ✔✔ -Performing an abdominal, pelvic, and rectovaginal examination
A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5 mg/dL
above normal without signs of nephrolithiasis. What is the recommended treatment for this
patient? - CORRECT ANSWER ✔✔ -Annual monitoring of calcium, creatinine, and bone
density
,A 45-year-old woman has gone 120 days without a menstrual period. A pregnancy test is
negative. What will the provider do, based on this symptom? - CORRECT ANSWER ✔✔ -
Evaluate for various causes of amenorrhea
A 50-year-old man reports having erectile dysfunction. What is an important response by the
provider when developing a plan of care for this patient? - CORRECT ANSWER ✔✔ -
Evaluating the patient for cardiovascular disease
A 60-year-old female patient has recently lost weight and a physical examination reveals a
beefy-red, sore tongue, with no neurological findings. Based on these clinical findings, what will
the provider anticipate finding in the laboratory data? - CORRECT ANSWER ✔✔ -Low
hemoglobin and elevated MCV
A 60-year-old patient reports new onset of bilateral shoulder pain with morning stiffness lasting
approximately one hour. Which will be NOT be included in initial diagnostic testing for this
patient? - CORRECT ANSWER ✔✔ -Serum Calcitonin
A 67-year-old female patient reports vulvar pruritus and dyspareunia. The provider notes white
papules on the vulva with thinning of the epithelium. What condition does the provider suspect?
- CORRECT ANSWER ✔✔ -Lichen sclerosis
A 69-year-old patient with cancer is reluctant to take an opioid agonist medication because of the
side effects. What will the primary care provider recommend? - CORRECT ANSWER ✔✔ -
Taking a stool softener with the opioid
, A child has a fever and arthralgia. The primary care nurse practitioner learns that the child had a
sore throat 3 weeks prior and auscultates a murmur in the clinic. Which test will the nurse
practitioner order? - CORRECT ANSWER ✔✔ -ASO Titer
A child has a high fever, bilateral conjunctivitis, and a desquamating rash and is presumed to
have a vasculitic disease. What is the likely treatment for this child? - CORRECT ANSWER ✔✔
-Aspirin and Intravenous immunoglobulin
A child has plaques on the extensor surfaces of both elbows and on the face with minimal scaling
and pruritis. What is the likely cause of these lesions? - CORRECT ANSWER ✔✔ -Psoriasis
A child has vesiculopustular lesions around the nose and mouth with areas of honey-colored
crusts. The provider notes a few similar lesions on the child's hands and legs. Which treatment is
appropriate for this child? - CORRECT ANSWER ✔✔ -Amoxicillin-clavulanate
A child is brought to a clinic with a sudden onset of rash after taking an antibiotic for 2 days. The
provider notes all over wheals with pruritis, which the parent reports seem to come and go.
Which action is correct? - CORRECT ANSWER ✔✔ -Admit the child to the hospital for
treatment and observation
A child who has atopic dermatitis has recurrent secondary bacterial skin infections. What will the
provider recommend to help prevent these infections? - CORRECT ANSWER ✔✔ -Bleach
baths twice weekly
A complete blood count on a 12-month-old infant reveals microcytic, hypochromic anemia with
a hemoglobin of 9.5 g/dL. The infar has mild pallor with no hepatosplenomegaly. The family
nurse practitioner suspects: - CORRECT ANSWER ✔✔ -Iron deficiency anemia
