NR509 Final Exam
A 35-year-old female with a history of migraines presents to the clinic with worsening symptoms for the
past few weeks. She reports waking up at night with headaches and nausea. Her only medication history
is oral contraceptive pills (OCPs). Otherwise, she states she is healthy. Which of the following actions if
taken by the NP is the best next step? - ANS: Take a further history and perform a very careful
neurological exam
A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination.
She asks you privately if her granddaughter has started puberty yet. During the examination, the NP
notes asymmetric projection of the areola and nipple of the right chest to form a secondary mound
above the level of the breast. The left breast is underdeveloped. These assessment findings are
consistent with which Tanner Stage of development? - ANS: IV
Primary prevention is defined as which of the following? - ANS: Interventions designed to prevent
disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following
statements is true about screening for breast cancer in average-risk women? - ANS: Mammography is
recommended every 2 years for women aged 50-74 with insufficient evidence for screening women over
the age of 75.
Which of the following statements is true regarding recommendations by the eighth Joint National
Committee (JNC8) for adults aged 60 and older? Select all that apply. - ANS: Target blood pressure
should be </= 150/90 mmHg but notes that if treatment results in SBP <140 and is "well tolerated and
without adverse effects to health or quality of live, treatment does not need to be adjusted."
In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear optimal for notable
reductions in stroke, cardiovascular events, and all-cause mortality.
Which of the following is a useful strategy when examining young children between the ages of 1 and 4?
- ANS: Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap).
The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which
statement from the parent may indicate a cardiac problem in the infant and require a more thorough
subjective history? - ANS: "It often takes the baby more than 30 minutes to finish a bottle."
A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as
represented in this image. He has no complaints and denies injury or trauma. Which cranial nerve (CN) is
involved in this condition?
, Patient with eyelid drooping - ANS: CNIII
Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions
of the tympanic membrane, auditory canal, pharynx, and the posterior third of the tongue? - ANS: CN IX
The NP should suspect injury to which cranial nerve (CN) if a patient presents with complaints of
photosensitivity and uneven pupils after being struck in the eye with a baseball? - ANS: CNIII
Which of the following statements is true regarding risks and rapid recognition of suspected stroke?
Select all that apply - ANS: Obesity doubles the risk of stroke even without associated glucose
intolerance
Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke
The combination of both receptive and expressive aphasia is a characteristic of which type of speech
disorder? - ANS: global aphasia
The NP is assessing a 42-year-old female who presents to the clinic with recurring headaches. What is an
effective question to ask the patient? - ANS: Do you have any aura prior to the headaches?
A 55-year-old female presents to the clinic with a headache. During the interview, which of the following
symptoms should prompt the NP to be concerned and investigate further? - ANS: The patient reports
fever, night sweats, and thinks she lost weight.
When grading muscle strength on a scale of 1 to 5, a grade of 3 indicates which of the following? - ANS:
Active movement against gravity
Which musculoskeletal disorder is paired correctly with the associated systemic manifestations? - ANS:
Lyme disease and expanding erythematous targetoid patch in early illness
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the following are expected
assessment findings consistent with the diagnosis? - ANS: Swelling of the synovial tissue in joints and
tendon sheaths.
A 58-year-old male complains of pain in his knees, hips, hands, wrists, neck, and lower back. Based on
the joints involved, the NP suspects that the patient most likely has which condition? - ANS:
Osteoarthritis
A 55-year-old male has a diagnosis of lumbar spinal stenosis. Which sign should the NP expect to find on
examination that is most consistent with the diagnosis? - ANS: Flexed forward posture with lower
extremity weakness
What is the action(s) of the erector spinae muscle group? - ANS: Extension of the spine
A 35-year-old female with a history of migraines presents to the clinic with worsening symptoms for the
past few weeks. She reports waking up at night with headaches and nausea. Her only medication history
is oral contraceptive pills (OCPs). Otherwise, she states she is healthy. Which of the following actions if
taken by the NP is the best next step? - ANS: Take a further history and perform a very careful
neurological exam
A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination.
She asks you privately if her granddaughter has started puberty yet. During the examination, the NP
notes asymmetric projection of the areola and nipple of the right chest to form a secondary mound
above the level of the breast. The left breast is underdeveloped. These assessment findings are
consistent with which Tanner Stage of development? - ANS: IV
Primary prevention is defined as which of the following? - ANS: Interventions designed to prevent
disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following
statements is true about screening for breast cancer in average-risk women? - ANS: Mammography is
recommended every 2 years for women aged 50-74 with insufficient evidence for screening women over
the age of 75.
Which of the following statements is true regarding recommendations by the eighth Joint National
Committee (JNC8) for adults aged 60 and older? Select all that apply. - ANS: Target blood pressure
should be </= 150/90 mmHg but notes that if treatment results in SBP <140 and is "well tolerated and
without adverse effects to health or quality of live, treatment does not need to be adjusted."
In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear optimal for notable
reductions in stroke, cardiovascular events, and all-cause mortality.
Which of the following is a useful strategy when examining young children between the ages of 1 and 4?
- ANS: Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap).
The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which
statement from the parent may indicate a cardiac problem in the infant and require a more thorough
subjective history? - ANS: "It often takes the baby more than 30 minutes to finish a bottle."
A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as
represented in this image. He has no complaints and denies injury or trauma. Which cranial nerve (CN) is
involved in this condition?
, Patient with eyelid drooping - ANS: CNIII
Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions
of the tympanic membrane, auditory canal, pharynx, and the posterior third of the tongue? - ANS: CN IX
The NP should suspect injury to which cranial nerve (CN) if a patient presents with complaints of
photosensitivity and uneven pupils after being struck in the eye with a baseball? - ANS: CNIII
Which of the following statements is true regarding risks and rapid recognition of suspected stroke?
Select all that apply - ANS: Obesity doubles the risk of stroke even without associated glucose
intolerance
Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke
The combination of both receptive and expressive aphasia is a characteristic of which type of speech
disorder? - ANS: global aphasia
The NP is assessing a 42-year-old female who presents to the clinic with recurring headaches. What is an
effective question to ask the patient? - ANS: Do you have any aura prior to the headaches?
A 55-year-old female presents to the clinic with a headache. During the interview, which of the following
symptoms should prompt the NP to be concerned and investigate further? - ANS: The patient reports
fever, night sweats, and thinks she lost weight.
When grading muscle strength on a scale of 1 to 5, a grade of 3 indicates which of the following? - ANS:
Active movement against gravity
Which musculoskeletal disorder is paired correctly with the associated systemic manifestations? - ANS:
Lyme disease and expanding erythematous targetoid patch in early illness
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the following are expected
assessment findings consistent with the diagnosis? - ANS: Swelling of the synovial tissue in joints and
tendon sheaths.
A 58-year-old male complains of pain in his knees, hips, hands, wrists, neck, and lower back. Based on
the joints involved, the NP suspects that the patient most likely has which condition? - ANS:
Osteoarthritis
A 55-year-old male has a diagnosis of lumbar spinal stenosis. Which sign should the NP expect to find on
examination that is most consistent with the diagnosis? - ANS: Flexed forward posture with lower
extremity weakness
What is the action(s) of the erector spinae muscle group? - ANS: Extension of the spine
