NR 509 FINAL EXAM LATEST ACTUAL
EXAM WITH COMPLETE QUESTIONS AND
CORRECT ANSWERS RATED A+
A 50-year-old male presents to the office for a routine
physical examination. He has no complaints. His PMH is
significant for non-alcoholic fatty liver disease and high
cholesterol for which he is taking fenofibrate. On the social
history intake form, he reported consuming 8 ounces of malt
liquor daily for 20 years. After a careful history and physical
examination, the NP documents the following nervous
system findings: Mental Status: Alert, relaxed, and
cooperative. Thought process coherent. Oriented to person,
place, and time. Speech is fluent, follows commands.
Detailed cognitive testing deferred. Cranial Nerves: I—not
tested; II through XII intact. Motor: Normal muscle bulk and
tone. Strength 5/5 throughout. No pronator drift. Cerebellar—
Rapid alternating movements (RAMs), finger-to-nose (F→N),
heel-to-shin (H→S) intact. Gait with normal stance and stride.
Sensory: Pinprick, light touch, position, and vibration intact.
Romberg— maintains balance with eyes closed. Reflexes: 2+
and symmetric with plantar reflexes downgoing. Which of the
following is the most accurate interpretation of these
findings?
These findings suggest no abdnormalities
Which cranial nerve (CN) is being assessed by the examiner
in this image? ADA Description: Examiner's hands placed on
,anterior shoulders while patient shrugs both shoulders
upward against hands.
CNXI
What assessment test is being performed in this image? ADA
Description: Tuning fork on top of the head.
Weber test
A 74-year-old man presents to the clinic for a scheduled
annual examination. He has a history of hypertension and
diabetes, both controlled with medication. He denies any
complaints. The NP performed a fundoscopic examination.
Identify the abnormal assessment findings in this image.
ADA Description: Accumulations of axoplasmic debris within
adjacent bundles of unmyelinated ganglion cell axons of the
retina.
Cotton wool spots
A 66-year-old female presents to the office for a focused visit
to discuss hypertension management strategies. During the
interview, the patient asks the NP if she could be screened
today for cervical cancer/HPV. Review of her medical record
reveals she was screened at ages 57, 60, and 63, with no
abnormal findings, and no history of cancer. What is the best
action the NP should take regarding the patient's request for
screening?
Deny her request, inform the patient that she has had three
negative screenings in the last 10 years and no longer requires
screening, and focus on the reason for the visit.
,Of the following statements, which is true regarding the
human papillomavirus (HPV) vaccine?
The vaccine can protect against anogenital lesions
A 21-year-old female presents for her first annual exam. She
reports concern because her female partner was recently
diagnosed with condyloma acuminata and wonders if she
could also be infected. If true, what physical assessment
findings would the NP expect to find during the speculum
examination?
Raised friable or lobed lesions
An 18-year-old female presents to the clinic complaining of a
thick and yellow vaginal discharge along with recent pelvic
pain. Her history is significant for pelvic inflammatory
disease (PID). During the speculum examination, the NP
would expect to find purulent discharge in the following
area(s) which is consistent with the diagnosis of PID?
Cervical os
A 23-year-old female presents to the clinic. She has decided
to discontinue using condoms and would like a different
birth control option. Her last pelvic exam was 2 years ago
when she had a negative Pap smear and STI screening. Her
LMP was 2 days ago, and she is still spotting. She last had
sex with her boyfriend 1 week ago. Condoms were used. The
NP elects to postpone her speculum exam during this office
encounter. What is the best evidence-based rationale for the
decision to postpone her exam?
She is on her menses
, A 24-year-old female presents to the clinic for an annual
exam. The NP proceeds to perform a Pap smear and
understands that the most important area on the cervix to
obtain cells for the Pap smear is where?
Transformation zone
A 45-year-old female presents to the clinic for heavy periods
and pelvic pain during her menses. She reached menarche at
age 13 years and has had regular periods except during her
pregnancies. She is a G4P3013 and does not use birth
control as her husband has had a vasectomy. She states this
has been going on for about a year but seems to be getting
worse. Her LMP was 1 week ago. On a bimanual exam, a
large midline mass halfway to the umbilicus is palpated.
Each adnexal area is nonpalpable. Her rectal exam is normal.
Her body mass index (BMI) is 27. Which of the following is
the most likely interpretation of these findings?
These findings suggest uterine fibroids
A 48-year-old female presents to the clinic with complaints of
heavy vaginal discharge and severe itching for 1 week. On
visualization of the vulva, a thick, white, curdy discharge is
seen at the introitus. On speculum examination, there is a
copious amount of this discharge. The pH of the discharge is
4.1 and the KOH whiff test is negative, with no unusual smell.
Wet prep shows budding hyphae. Which of the following is
the most accurate interpretation of these findings?
These findings suggest candida vaginitis
Cervical motion tenderness and/or adnexal tenderness are
hallmarks of all the following conditions, EXCEPT?
EXAM WITH COMPLETE QUESTIONS AND
CORRECT ANSWERS RATED A+
A 50-year-old male presents to the office for a routine
physical examination. He has no complaints. His PMH is
significant for non-alcoholic fatty liver disease and high
cholesterol for which he is taking fenofibrate. On the social
history intake form, he reported consuming 8 ounces of malt
liquor daily for 20 years. After a careful history and physical
examination, the NP documents the following nervous
system findings: Mental Status: Alert, relaxed, and
cooperative. Thought process coherent. Oriented to person,
place, and time. Speech is fluent, follows commands.
Detailed cognitive testing deferred. Cranial Nerves: I—not
tested; II through XII intact. Motor: Normal muscle bulk and
tone. Strength 5/5 throughout. No pronator drift. Cerebellar—
Rapid alternating movements (RAMs), finger-to-nose (F→N),
heel-to-shin (H→S) intact. Gait with normal stance and stride.
Sensory: Pinprick, light touch, position, and vibration intact.
Romberg— maintains balance with eyes closed. Reflexes: 2+
and symmetric with plantar reflexes downgoing. Which of the
following is the most accurate interpretation of these
findings?
These findings suggest no abdnormalities
Which cranial nerve (CN) is being assessed by the examiner
in this image? ADA Description: Examiner's hands placed on
,anterior shoulders while patient shrugs both shoulders
upward against hands.
CNXI
What assessment test is being performed in this image? ADA
Description: Tuning fork on top of the head.
Weber test
A 74-year-old man presents to the clinic for a scheduled
annual examination. He has a history of hypertension and
diabetes, both controlled with medication. He denies any
complaints. The NP performed a fundoscopic examination.
Identify the abnormal assessment findings in this image.
ADA Description: Accumulations of axoplasmic debris within
adjacent bundles of unmyelinated ganglion cell axons of the
retina.
Cotton wool spots
A 66-year-old female presents to the office for a focused visit
to discuss hypertension management strategies. During the
interview, the patient asks the NP if she could be screened
today for cervical cancer/HPV. Review of her medical record
reveals she was screened at ages 57, 60, and 63, with no
abnormal findings, and no history of cancer. What is the best
action the NP should take regarding the patient's request for
screening?
Deny her request, inform the patient that she has had three
negative screenings in the last 10 years and no longer requires
screening, and focus on the reason for the visit.
,Of the following statements, which is true regarding the
human papillomavirus (HPV) vaccine?
The vaccine can protect against anogenital lesions
A 21-year-old female presents for her first annual exam. She
reports concern because her female partner was recently
diagnosed with condyloma acuminata and wonders if she
could also be infected. If true, what physical assessment
findings would the NP expect to find during the speculum
examination?
Raised friable or lobed lesions
An 18-year-old female presents to the clinic complaining of a
thick and yellow vaginal discharge along with recent pelvic
pain. Her history is significant for pelvic inflammatory
disease (PID). During the speculum examination, the NP
would expect to find purulent discharge in the following
area(s) which is consistent with the diagnosis of PID?
Cervical os
A 23-year-old female presents to the clinic. She has decided
to discontinue using condoms and would like a different
birth control option. Her last pelvic exam was 2 years ago
when she had a negative Pap smear and STI screening. Her
LMP was 2 days ago, and she is still spotting. She last had
sex with her boyfriend 1 week ago. Condoms were used. The
NP elects to postpone her speculum exam during this office
encounter. What is the best evidence-based rationale for the
decision to postpone her exam?
She is on her menses
, A 24-year-old female presents to the clinic for an annual
exam. The NP proceeds to perform a Pap smear and
understands that the most important area on the cervix to
obtain cells for the Pap smear is where?
Transformation zone
A 45-year-old female presents to the clinic for heavy periods
and pelvic pain during her menses. She reached menarche at
age 13 years and has had regular periods except during her
pregnancies. She is a G4P3013 and does not use birth
control as her husband has had a vasectomy. She states this
has been going on for about a year but seems to be getting
worse. Her LMP was 1 week ago. On a bimanual exam, a
large midline mass halfway to the umbilicus is palpated.
Each adnexal area is nonpalpable. Her rectal exam is normal.
Her body mass index (BMI) is 27. Which of the following is
the most likely interpretation of these findings?
These findings suggest uterine fibroids
A 48-year-old female presents to the clinic with complaints of
heavy vaginal discharge and severe itching for 1 week. On
visualization of the vulva, a thick, white, curdy discharge is
seen at the introitus. On speculum examination, there is a
copious amount of this discharge. The pH of the discharge is
4.1 and the KOH whiff test is negative, with no unusual smell.
Wet prep shows budding hyphae. Which of the following is
the most accurate interpretation of these findings?
These findings suggest candida vaginitis
Cervical motion tenderness and/or adnexal tenderness are
hallmarks of all the following conditions, EXCEPT?
