FNP 654 FINAL EXAM 315 QUESTIONS AND
ANSWERS (LATEST UPDATE 2024/2025)
ALREADY GRADED A.
A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to have symptoms that
include asymmetric weakness in the arms and difficulty walking. The neurologist recognizes these
symptoms as characteristic of involvement of which portion of the nervous system?
- CORRECT ANSWER - Lower motor neurons
The spouse of a patient newly-diagnosed with amyotrophic lateral sclerosis (ALS) asks about long-term
care. What will the provider include when teaching the family about this disease?
- CORRECT ANSWER - Preventing malnutrition is a key element in care.
Which symptoms may occur with Bell's palsy? Select all that apply.
- CORRECT ANSWER - Alteration in taste, Drooling, Tinnitus
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
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?
- CORRECT ANSWER - Lubricating eye drops
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?
- CORRECT ANSWER - The Hallpike-Dix positioning maneuver
An elderly patient reports sensation of being off balance when walking, but does not experience dizziness.
The provider will refer this patient to which specialist for further evaluation?
- CORRECT ANSWER - Neurologist
Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is
developing muscle weakness and paresthesia?
- CORRECT ANSWER - Lumbar puncture
Which monitoring parameters are necessary when caring for a patient with Guillain-Barre syndrome?
Select all that apply.
- CORRECT ANSWER - Bladder scans Cardiac telemetry Fever
Vital capacity measures
Following an upper respiratory infection, a patient begins to develop ataxia and distal paresthesias, along
with oculomotor symptoms and double vision. Based on these presenting symptoms which type of GBS
does this patient have?
- CORRECT ANSWER - Miller Fisher syndrome (MFS)
A patient has recurrent cluster headaches and asks about abortive therapy. Which therapy is effective for a
majority of patients with cluster headaches?
- CORRECT ANSWER - Oxygen
,A patient reports recurrent headaches occurring 1 or 2 times per month that generally occur with weather
changes or when sleep patterns are disrupted and describes them as severe, with throbbing on one side of
the head and sometimes accompanied by nausea. What is the recommended treatment for this type of
headache?
- CORRECT ANSWER - Rizatriptan
Which medications may be useful in treating tension-type headache? Select all that apply.
- CORRECT ANSWER - Antiemetics Muscle relaxants NSAIDs
A provider suspects that a patient has bacterial meningitis. When should antibiotics be given?
- CORRECT ANSWER - Prior to obtaining a CT scan or lumbar puncture
A patient is brought to the emergency department with fever, lethargy, and headache without meningeal
signs. The examination reveals hypotension and lethargy and the examiner notes petechiae on the patient's
trunk. What do these findings indicate?
- CORRECT ANSWER - A poor prognosis
A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2 days each about 2
months apart. Which diagnostic testing will the provider order initially?
- CORRECT ANSWER - Magnetic resonance imaging
A patient diagnosed with multiple sclerosis and begins disease modulating therapy drugs. As part of the
counseling about this therapy, the provider will tell the patient that this regimen will
- CORRECT ANSWER - reduce the exacerbation rate.
A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency department
with a seizure which has persisted for15 minutes and which immediately followed another 15-minute
seizure. What is the priority action for this patient?
- CORRECT ANSWER - Administer lorazepam and monitor cardiorespiratory status
A patient with a seizure disorder has seizures which begin with eye twitching and occasionally visual
hallucinations. Which site in the brain is the seizure focus?
- CORRECT ANSWER - Occipital
Which drug is used to treat patients with focal epilepsy and complex partial seizures?
- CORRECT ANSWER - Carbamazepine
A patient reports paroxysms of burning, shock-like pain on both sides of the face usually triggered by
chewing or talking. The provider suspects trigeminal neuralgia. Based on these presenting symptoms,
what testing is indicated?
- CORRECT ANSWER - Magnetic resonance imaging
A patient with trigeminal neuralgia has tried several medication regimens to control pain without success.
What is the next step in management for this condition?
- CORRECT ANSWER - Referral to a neurosurgeon
A patient is diagnosed with trigeminal neuralgia and reports having paroxysms several times each day.
What is the initial treatment for this patient?
- CORRECT ANSWER - A high dose of carbamazepine with subsequent titration downward
A patient develops a gait disorder and the patient's spouse reports noticing recent personality changes.
The provider suspects a brain lesion. Which evaluation is especially important in the initial physical
examination?
- CORRECT ANSWER - Examination of the optic fundi
Which is the preferred treatment for primary brain tumors?
, - CORRECT ANSWER - Surgical resection
A patient is diagnosed with panic disorder and begins taking a selective serotonin reuptake inhibitor
medication. Six weeks later, the patient reports little relief from symptoms. What will the provider do
next to manage this patient?
- CORRECT ANSWER - Refer to a mental health provider
Which medication are useful in treating both obsessive-compulsive disorder and PTSD? Select all that
apply.
- CORRECT ANSWER - Selective serotonin reuptake inhibitors Serotonin-norepinephrine reuptake
inhibitors Tricyclic antidepressants
A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines
that these symptoms occur in relation to many events and concerns. What other things will the provider
question this patient about?
- CORRECT ANSWER - Headaches and bowel habits
A patient is seen in clinic 2 weeks after the death of a parent. The patient reports feelings of sadness and
hopelessness and a feeling that the parent is still present, even to the point of hearing the parent's voice at
times. What will the provider determine from these findings?
- CORRECT ANSWER - These are normal grief responses.
A college student is brought to clinic by a parent who is concerned about increasingly bizarre behavior
and poor school performance. The provider notes difficulty engaging the patient in an organized
conversation. The patient denies any concerns about behavior. What will the provider do initially to
manage this patient's symptoms?
- CORRECT ANSWER - Begin treatment with lithium or lamotrigine
A patient is seen frequently over a 9-month period with somatic complaints that are not related to physical
disease. The primary provider notes that the patient has had a 15% weight loss in the previous 2 months
and the patient reports difficulty sleeping. The spouse tells the provider that the patient seems tired all the
time and is irritable with other family members. What will the provider do initially?
- CORRECT ANSWER - Perform a suicide risk assessment
A patient is brought to the emergency department who is experiencing disorientation, confusion, and
fever. The patient describes visual and auditory hallucinations. The patient's spouse states that the patient
had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended
treatment?
- CORRECT ANSWER - Benzodiazepines
A college student is brought to the emergency department by a roommate who is concerned about
symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and
blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects
withdrawal from which substance?
- CORRECT ANSWER - Opioids
A 17-year-old male is brought to the clinic by a parent who is concerned that the patient has become more
isolated and withdrawn and expresses suspicions that his teachers hate him and want him to fail. What
will the provider tell this parent?
- CORRECT ANSWER - The adolescent should be evaluated by a psychiatrist.
A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of
college and quit his job within the last 5 months. The parent is concerned that the patient may have
schizophrenia because a maternal uncle has the disease. What will the provider do next?
- CORRECT ANSWER - Ask about the patient's speech and thinking patterns
ANSWERS (LATEST UPDATE 2024/2025)
ALREADY GRADED A.
A patient with a family history of amyotrophic lateral sclerosis (ALS) begins to have symptoms that
include asymmetric weakness in the arms and difficulty walking. The neurologist recognizes these
symptoms as characteristic of involvement of which portion of the nervous system?
- CORRECT ANSWER - Lower motor neurons
The spouse of a patient newly-diagnosed with amyotrophic lateral sclerosis (ALS) asks about long-term
care. What will the provider include when teaching the family about this disease?
- CORRECT ANSWER - Preventing malnutrition is a key element in care.
Which symptoms may occur with Bell's palsy? Select all that apply.
- CORRECT ANSWER - Alteration in taste, Drooling, Tinnitus
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
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?
- CORRECT ANSWER - Lubricating eye drops
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?
- CORRECT ANSWER - The Hallpike-Dix positioning maneuver
An elderly patient reports sensation of being off balance when walking, but does not experience dizziness.
The provider will refer this patient to which specialist for further evaluation?
- CORRECT ANSWER - Neurologist
Which diagnostic test helps confirm a diagnosis of Guillain-Barre syndrome in a patient who is
developing muscle weakness and paresthesia?
- CORRECT ANSWER - Lumbar puncture
Which monitoring parameters are necessary when caring for a patient with Guillain-Barre syndrome?
Select all that apply.
- CORRECT ANSWER - Bladder scans Cardiac telemetry Fever
Vital capacity measures
Following an upper respiratory infection, a patient begins to develop ataxia and distal paresthesias, along
with oculomotor symptoms and double vision. Based on these presenting symptoms which type of GBS
does this patient have?
- CORRECT ANSWER - Miller Fisher syndrome (MFS)
A patient has recurrent cluster headaches and asks about abortive therapy. Which therapy is effective for a
majority of patients with cluster headaches?
- CORRECT ANSWER - Oxygen
,A patient reports recurrent headaches occurring 1 or 2 times per month that generally occur with weather
changes or when sleep patterns are disrupted and describes them as severe, with throbbing on one side of
the head and sometimes accompanied by nausea. What is the recommended treatment for this type of
headache?
- CORRECT ANSWER - Rizatriptan
Which medications may be useful in treating tension-type headache? Select all that apply.
- CORRECT ANSWER - Antiemetics Muscle relaxants NSAIDs
A provider suspects that a patient has bacterial meningitis. When should antibiotics be given?
- CORRECT ANSWER - Prior to obtaining a CT scan or lumbar puncture
A patient is brought to the emergency department with fever, lethargy, and headache without meningeal
signs. The examination reveals hypotension and lethargy and the examiner notes petechiae on the patient's
trunk. What do these findings indicate?
- CORRECT ANSWER - A poor prognosis
A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2 days each about 2
months apart. Which diagnostic testing will the provider order initially?
- CORRECT ANSWER - Magnetic resonance imaging
A patient diagnosed with multiple sclerosis and begins disease modulating therapy drugs. As part of the
counseling about this therapy, the provider will tell the patient that this regimen will
- CORRECT ANSWER - reduce the exacerbation rate.
A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency department
with a seizure which has persisted for15 minutes and which immediately followed another 15-minute
seizure. What is the priority action for this patient?
- CORRECT ANSWER - Administer lorazepam and monitor cardiorespiratory status
A patient with a seizure disorder has seizures which begin with eye twitching and occasionally visual
hallucinations. Which site in the brain is the seizure focus?
- CORRECT ANSWER - Occipital
Which drug is used to treat patients with focal epilepsy and complex partial seizures?
- CORRECT ANSWER - Carbamazepine
A patient reports paroxysms of burning, shock-like pain on both sides of the face usually triggered by
chewing or talking. The provider suspects trigeminal neuralgia. Based on these presenting symptoms,
what testing is indicated?
- CORRECT ANSWER - Magnetic resonance imaging
A patient with trigeminal neuralgia has tried several medication regimens to control pain without success.
What is the next step in management for this condition?
- CORRECT ANSWER - Referral to a neurosurgeon
A patient is diagnosed with trigeminal neuralgia and reports having paroxysms several times each day.
What is the initial treatment for this patient?
- CORRECT ANSWER - A high dose of carbamazepine with subsequent titration downward
A patient develops a gait disorder and the patient's spouse reports noticing recent personality changes.
The provider suspects a brain lesion. Which evaluation is especially important in the initial physical
examination?
- CORRECT ANSWER - Examination of the optic fundi
Which is the preferred treatment for primary brain tumors?
, - CORRECT ANSWER - Surgical resection
A patient is diagnosed with panic disorder and begins taking a selective serotonin reuptake inhibitor
medication. Six weeks later, the patient reports little relief from symptoms. What will the provider do
next to manage this patient?
- CORRECT ANSWER - Refer to a mental health provider
Which medication are useful in treating both obsessive-compulsive disorder and PTSD? Select all that
apply.
- CORRECT ANSWER - Selective serotonin reuptake inhibitors Serotonin-norepinephrine reuptake
inhibitors Tricyclic antidepressants
A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines
that these symptoms occur in relation to many events and concerns. What other things will the provider
question this patient about?
- CORRECT ANSWER - Headaches and bowel habits
A patient is seen in clinic 2 weeks after the death of a parent. The patient reports feelings of sadness and
hopelessness and a feeling that the parent is still present, even to the point of hearing the parent's voice at
times. What will the provider determine from these findings?
- CORRECT ANSWER - These are normal grief responses.
A college student is brought to clinic by a parent who is concerned about increasingly bizarre behavior
and poor school performance. The provider notes difficulty engaging the patient in an organized
conversation. The patient denies any concerns about behavior. What will the provider do initially to
manage this patient's symptoms?
- CORRECT ANSWER - Begin treatment with lithium or lamotrigine
A patient is seen frequently over a 9-month period with somatic complaints that are not related to physical
disease. The primary provider notes that the patient has had a 15% weight loss in the previous 2 months
and the patient reports difficulty sleeping. The spouse tells the provider that the patient seems tired all the
time and is irritable with other family members. What will the provider do initially?
- CORRECT ANSWER - Perform a suicide risk assessment
A patient is brought to the emergency department who is experiencing disorientation, confusion, and
fever. The patient describes visual and auditory hallucinations. The patient's spouse states that the patient
had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended
treatment?
- CORRECT ANSWER - Benzodiazepines
A college student is brought to the emergency department by a roommate who is concerned about
symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and
blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects
withdrawal from which substance?
- CORRECT ANSWER - Opioids
A 17-year-old male is brought to the clinic by a parent who is concerned that the patient has become more
isolated and withdrawn and expresses suspicions that his teachers hate him and want him to fail. What
will the provider tell this parent?
- CORRECT ANSWER - The adolescent should be evaluated by a psychiatrist.
A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of
college and quit his job within the last 5 months. The parent is concerned that the patient may have
schizophrenia because a maternal uncle has the disease. What will the provider do next?
- CORRECT ANSWER - Ask about the patient's speech and thinking patterns
