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?
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?
IV
Primary prevention is defined as which of the following?
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?
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.
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?
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?
"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
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?
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?
CNIII
Which of the following statements is true regarding risks and rapid recognition of suspected
stroke? Select all that apply
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?
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?
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?
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?
Active movement against gravity
Which musculoskeletal disorder is paired correctly with the associated systemic manifestations?
Lyme disease and expanding erythematous targetoid patch in early illness
We have an expert-written solution to this problem!
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the following are
expected assessment findings consistent with the diagnosis?
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?
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?
Flexed forward posture with lower extremity weakness
We have an expert-written solution to this problem!
What is the action(s) of the erector spinae muscle group?
Extension of the spine
A 17-year-old male presents to the clinic for a follow-up appointment. He fractured his left arm 8
weeks ago and remains in a cast. Upon inspection, the NP finds that his shoulder heights are
unequal and there is winging of the scapula. The NP suspects contralateral weakness and
muscle wasting as the etiology for the winged scapula. Which of the following physical
assessment maneuvers should the NP perform to confirm the suspension?
Compare the strength of the trapezius muscles
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?
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?
IV
Primary prevention is defined as which of the following?
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?
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.
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?
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?
"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
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?
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?
CNIII
Which of the following statements is true regarding risks and rapid recognition of suspected
stroke? Select all that apply
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?
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?
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?
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?
Active movement against gravity
Which musculoskeletal disorder is paired correctly with the associated systemic manifestations?
Lyme disease and expanding erythematous targetoid patch in early illness
We have an expert-written solution to this problem!
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the following are
expected assessment findings consistent with the diagnosis?
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?
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?
Flexed forward posture with lower extremity weakness
We have an expert-written solution to this problem!
What is the action(s) of the erector spinae muscle group?
Extension of the spine
A 17-year-old male presents to the clinic for a follow-up appointment. He fractured his left arm 8
weeks ago and remains in a cast. Upon inspection, the NP finds that his shoulder heights are
unequal and there is winging of the scapula. The NP suspects contralateral weakness and
muscle wasting as the etiology for the winged scapula. Which of the following physical
assessment maneuvers should the NP perform to confirm the suspension?
Compare the strength of the trapezius muscles
