NR509 Final Exam 88 QUESTIONS AND ANSWERS
1. 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?
Answer> Take a further history and perform a very careful neurological exam
2. 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 develop-
ment?
Answer> IV
3. Primary prevention is defined as which of the following?
Answer> Interventions de- signed to prevent disease
4. Based on the U.S. Preventive Services Task Force (USPSTF) recommenda-
,tions, which of the following statements is true about screening for breast
cancer in average-risk women?
Answer> Mammography is recommended every 2 years for women aged 50-74
with insufficient evidence for screening women over the age of 75.
5. 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.
Answer> 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 mor-
tality.
6. Which of the following is a useful strategy when examining young children
between the ages of 1 and 4?
Answer> Have the parent facilitate the exam (e.g., removing clothes, holding the
child on lap).
7. 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?
Answer> "It often takes the baby more than 30 minutes to finish a bottle."
8. 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
Answer> CNIII
9. Which cranial nerve (CN) innervates the muscles of the pharynx and pro-
vides sensory fibers to portions of the tympanic membrane, auditory canal,
pharynx, and the posterior third of the tongue?
Answer> CN IX
10. 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?
Answer> CNIII
11. Which of the following statements is true regarding risks and rapid recog-
nition of suspected stroke? Select all that apply
, Answer> Obesity doubles the risk of stroke even without associated glucose
intolerance
Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke
12. The combination of both receptive and expressive aphasia is a character-
istic of which type of speech disorder?
Answer> global aphasia
13. 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?
Answer> Do you have any aura prior to the headaches?
14. 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?
Answer> The patient reports fever, night sweats, and thinks she lost weight.
15. When grading muscle strength on a scale of 1 to 5, a grade of 3 indicates
which of the following?
Answer> Active movement against gravity
16. Which musculoskeletal disorder is paired correctly with the associated
systemic manifestations?
Answer> Lyme disease and expanding erythematous targetoid patch in early
1. 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?
Answer> Take a further history and perform a very careful neurological exam
2. 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 develop-
ment?
Answer> IV
3. Primary prevention is defined as which of the following?
Answer> Interventions de- signed to prevent disease
4. Based on the U.S. Preventive Services Task Force (USPSTF) recommenda-
,tions, which of the following statements is true about screening for breast
cancer in average-risk women?
Answer> Mammography is recommended every 2 years for women aged 50-74
with insufficient evidence for screening women over the age of 75.
5. 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.
Answer> 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 mor-
tality.
6. Which of the following is a useful strategy when examining young children
between the ages of 1 and 4?
Answer> Have the parent facilitate the exam (e.g., removing clothes, holding the
child on lap).
7. 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?
Answer> "It often takes the baby more than 30 minutes to finish a bottle."
8. 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
Answer> CNIII
9. Which cranial nerve (CN) innervates the muscles of the pharynx and pro-
vides sensory fibers to portions of the tympanic membrane, auditory canal,
pharynx, and the posterior third of the tongue?
Answer> CN IX
10. 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?
Answer> CNIII
11. Which of the following statements is true regarding risks and rapid recog-
nition of suspected stroke? Select all that apply
, Answer> Obesity doubles the risk of stroke even without associated glucose
intolerance
Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke
12. The combination of both receptive and expressive aphasia is a character-
istic of which type of speech disorder?
Answer> global aphasia
13. 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?
Answer> Do you have any aura prior to the headaches?
14. 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?
Answer> The patient reports fever, night sweats, and thinks she lost weight.
15. When grading muscle strength on a scale of 1 to 5, a grade of 3 indicates
which of the following?
Answer> Active movement against gravity
16. Which musculoskeletal disorder is paired correctly with the associated
systemic manifestations?
Answer> Lyme disease and expanding erythematous targetoid patch in early
