A patient presents to the hospital complaining of blurred vision, muscle weaknesses, impaired gait,
and fatigue lasting more than 24 hours. The patient has a history of smoking and vitamin D
deficiency. Extensive diagnostic testing and a comprehensive neurological assessment reveals a
diagnosis of multiple sclerosis. Which pathological mechanism will support this diagnosis?
A loss of myelin sheaths, causing a disruption of nerve conduction
Demyelination caused by antibody and cell-mediated immunologic reaction of the peripheral nerves
A defect in nerve impulse transmission at the neuromuscular junction
Degeneration of the neuromuscular junction and the upper and lower motor neurons - CORRECT
ANS - A loss of myelin sheaths, causing a disruption of nerve conduction
A child presents to a clinic with a white pupillary reflex noted in the right eye. The child is constantly
crying and rubbing her eyes. An advanced practice registered nurse (APRN) performs a complete
ophthalmologic examination and orders several diagnostic tests. Based on the findings, a diagnosis of
retinoblastoma is confirmed. What is the pathological mechanism of this disorder?
Autosomal dominant linked to genes results in mutations on chromosome 21
Deficiency of hexosaminidase causes accumulation enzymes that damage the brain
Mutations of a gene on chromosome 13q14 lead to neoplastic proliferation of cells
Invasion of astrocytomas of the brain structure destroys normal defenses - CORRECT ANS -
Mutations of a gene on chromosome 13q14 lead to neoplastic proliferation of cells
A patient is seen by an advanced practice registered nurse (APRN) at a primary care clinic for follow-
up to discuss abnormal results of testing for peripheral nervous system impairment. Which diagnosis
should the APRN suspect?
Autonomic hyperreflexia
Diffuse axonal injury
Spinal cord injury
Demyelinating polyneuropathy - CORRECT ANS - Demyelinating polyneuropathy
,A patient is seen in the clinic after being a restrained passenger in a car accident the previous week.
The patient continues to have intermittent headaches and has noticed periods of forgetfulness.
Assessment findings include a BP of 130/82 mm Hg and an apical pulse rate of 72 bpm. An advanced
practice registered nurse (APRN) is concerned that the symptoms might stem from a specific process.
Which process should the APRN be concerned about?
Decreased cerebral perfusion
Subarachnoid hemorrhage
Cerebral concussion
Skull fracture - CORRECT ANS - Cerebral concussion
An advanced practice registered nurse (APRN) is examining an adolescent patient who describes
hearing voices telling her to gather weapons because the government is trying to control her. The
patient also describes feelings of happiness related to a tragic personal event. What is the probable
diagnosis?
Bipolar disorder
Obsessive compulsive disorder
Panic attack
Schizophrenia - CORRECT ANS - Schizophrenia
A patient is seeing an advanced practice registered nurse (APRN) in an occupational health setting.
The patient has been referred by employee assistance for reckless and self-destructive behaviors and a
violent incident at work regarding a fellow employee. The APRN suspects post-traumatic stress
disorder (PTSD). Which diagnostic cluster of PTSD is the patient exhibiting?
Negative cognitions
Avoidance
Reexperiencing
Arousal - CORRECT ANS - Arousal
A 45-year-old male patient with altered testosterone levels needs treatment. An advanced practice
registered nurse (APRN) is aware that three factors affect hormone target cell responses when
determining a treatment approach.Which factor should be considered by the APRN?
Limited concentration of organs
Change of target cell sensitivity
,Affinity of receptor for the hormones
Limited number of target cell receptors - CORRECT ANS - Affinity of receptor for the hormones
An advanced practice registered nurse (APRN) is consulting with a teen patient who has recently
learned that she is pregnant. The APRN knows that a certain medication taken by the patient can
contribute to the development of congenital malformations in the fetus. The APRN reviews the
patient's current medication list and finds one medication that is a concern.
Which medication is the APRN concerned about?
Retinoic acid
Clindamycin
Benzoyl peroxide
Bisphenol A - CORRECT ANS - Retinoic acid
A newborn's screening for cystic fibrosis is positive. An advanced practice registered nurse (APRN) is
reviewing screening results and taking a comprehensive genetic screening of the parents. The APRN
asks the parents questions to help determine the transmission of this disease.
Which question should the APRN ask?
"Do any of your siblings have cystic fibrosis?"
"Do you wish to have maternal genetic testing done?"
"Are either of you showing symptoms of cystic fibrosis?"
"Are you both the genetic donor parents?" - CORRECT ANS - "Are you both the genetic donor
parents?"
A 30-day-old infant presents to the emergency room with decreased oral intake, decreased urine
output, and a fever of 101.8. The infant is admitted for further evaluation with a workup to include a
blood culture, a urine culture, a spinal tap, and a chest X-ray. Which issue of innate immunity, as it
relates to neonates, is of concern?
High levels of mannose-binding lectin
Relative deficiency of factor B
Excess collecting and collecting-like protein
Dysfunctional chemotactic factor response - CORRECT ANS - Relative deficiency of factor B
, A 12-year-old African American patient presents with unilateral eye swelling and lower lip swelling.
The patient's parent reports that the swelling is spontaneous and resolves over several days. The
patient does not have complaints of fever, hives, or vomiting. Serum lab results show hyperactivation
of three plasma protein systems. The
APRN suspects hereditary angioedema. What is the cause of the genetic defect suspected in this
situation?
Plasminogen
Hageman factor
Bradykinin
C1 esterase inhibitor - CORRECT ANS - C1 esterase inhibitor
The parent of a child diagnosed with Down syndrome expresses concerns about the child's recurrent
respiratory tract infections to an advanced practice registered nurse (APRN). The infections have
occurred regularly since birth. What should the APRN tell the parent is the underlying cause of this
illness?
Hyperthyroidism causes an increased risk of infection.
Gastroesophageal reflux disease causes aspiration of thin fluids.
Hypertonia causes airway restriction.
Short stature causes poor lung development. - CORRECT ANS - Gastroesophageal reflux disease
causes aspiration of thin fluids.
A 36-year-old patient is being seen by an advanced practice registered nurse (APRN) in a primary
care clinic for the first time. The patient reports feeling depressed due to a major life change.
Additional symptoms include weight gain, sedentary activity, and insomnia. The APRN plans on
providing the patient with several exercises to reduce the physiological effect of stress. Why is the
APRN concerned about relieving this emotional response?
It increases protein synthesis.
It increases smooth muscle contraction.
It decreases glucose uptake. - CORRECT ANS - It decreases glucose uptake.
An 80-year-old patient brings her grandchildren with her to a routine medical appointment. The
patient has moderate chronic obstructive pulmonary disease (COPD) and is concerned about
developing pneumonia because of its increased incidence at the senior center. What should the nurse
practitioner recommend for this patient?
Avoiding her grandchildren this winter
and fatigue lasting more than 24 hours. The patient has a history of smoking and vitamin D
deficiency. Extensive diagnostic testing and a comprehensive neurological assessment reveals a
diagnosis of multiple sclerosis. Which pathological mechanism will support this diagnosis?
A loss of myelin sheaths, causing a disruption of nerve conduction
Demyelination caused by antibody and cell-mediated immunologic reaction of the peripheral nerves
A defect in nerve impulse transmission at the neuromuscular junction
Degeneration of the neuromuscular junction and the upper and lower motor neurons - CORRECT
ANS - A loss of myelin sheaths, causing a disruption of nerve conduction
A child presents to a clinic with a white pupillary reflex noted in the right eye. The child is constantly
crying and rubbing her eyes. An advanced practice registered nurse (APRN) performs a complete
ophthalmologic examination and orders several diagnostic tests. Based on the findings, a diagnosis of
retinoblastoma is confirmed. What is the pathological mechanism of this disorder?
Autosomal dominant linked to genes results in mutations on chromosome 21
Deficiency of hexosaminidase causes accumulation enzymes that damage the brain
Mutations of a gene on chromosome 13q14 lead to neoplastic proliferation of cells
Invasion of astrocytomas of the brain structure destroys normal defenses - CORRECT ANS -
Mutations of a gene on chromosome 13q14 lead to neoplastic proliferation of cells
A patient is seen by an advanced practice registered nurse (APRN) at a primary care clinic for follow-
up to discuss abnormal results of testing for peripheral nervous system impairment. Which diagnosis
should the APRN suspect?
Autonomic hyperreflexia
Diffuse axonal injury
Spinal cord injury
Demyelinating polyneuropathy - CORRECT ANS - Demyelinating polyneuropathy
,A patient is seen in the clinic after being a restrained passenger in a car accident the previous week.
The patient continues to have intermittent headaches and has noticed periods of forgetfulness.
Assessment findings include a BP of 130/82 mm Hg and an apical pulse rate of 72 bpm. An advanced
practice registered nurse (APRN) is concerned that the symptoms might stem from a specific process.
Which process should the APRN be concerned about?
Decreased cerebral perfusion
Subarachnoid hemorrhage
Cerebral concussion
Skull fracture - CORRECT ANS - Cerebral concussion
An advanced practice registered nurse (APRN) is examining an adolescent patient who describes
hearing voices telling her to gather weapons because the government is trying to control her. The
patient also describes feelings of happiness related to a tragic personal event. What is the probable
diagnosis?
Bipolar disorder
Obsessive compulsive disorder
Panic attack
Schizophrenia - CORRECT ANS - Schizophrenia
A patient is seeing an advanced practice registered nurse (APRN) in an occupational health setting.
The patient has been referred by employee assistance for reckless and self-destructive behaviors and a
violent incident at work regarding a fellow employee. The APRN suspects post-traumatic stress
disorder (PTSD). Which diagnostic cluster of PTSD is the patient exhibiting?
Negative cognitions
Avoidance
Reexperiencing
Arousal - CORRECT ANS - Arousal
A 45-year-old male patient with altered testosterone levels needs treatment. An advanced practice
registered nurse (APRN) is aware that three factors affect hormone target cell responses when
determining a treatment approach.Which factor should be considered by the APRN?
Limited concentration of organs
Change of target cell sensitivity
,Affinity of receptor for the hormones
Limited number of target cell receptors - CORRECT ANS - Affinity of receptor for the hormones
An advanced practice registered nurse (APRN) is consulting with a teen patient who has recently
learned that she is pregnant. The APRN knows that a certain medication taken by the patient can
contribute to the development of congenital malformations in the fetus. The APRN reviews the
patient's current medication list and finds one medication that is a concern.
Which medication is the APRN concerned about?
Retinoic acid
Clindamycin
Benzoyl peroxide
Bisphenol A - CORRECT ANS - Retinoic acid
A newborn's screening for cystic fibrosis is positive. An advanced practice registered nurse (APRN) is
reviewing screening results and taking a comprehensive genetic screening of the parents. The APRN
asks the parents questions to help determine the transmission of this disease.
Which question should the APRN ask?
"Do any of your siblings have cystic fibrosis?"
"Do you wish to have maternal genetic testing done?"
"Are either of you showing symptoms of cystic fibrosis?"
"Are you both the genetic donor parents?" - CORRECT ANS - "Are you both the genetic donor
parents?"
A 30-day-old infant presents to the emergency room with decreased oral intake, decreased urine
output, and a fever of 101.8. The infant is admitted for further evaluation with a workup to include a
blood culture, a urine culture, a spinal tap, and a chest X-ray. Which issue of innate immunity, as it
relates to neonates, is of concern?
High levels of mannose-binding lectin
Relative deficiency of factor B
Excess collecting and collecting-like protein
Dysfunctional chemotactic factor response - CORRECT ANS - Relative deficiency of factor B
, A 12-year-old African American patient presents with unilateral eye swelling and lower lip swelling.
The patient's parent reports that the swelling is spontaneous and resolves over several days. The
patient does not have complaints of fever, hives, or vomiting. Serum lab results show hyperactivation
of three plasma protein systems. The
APRN suspects hereditary angioedema. What is the cause of the genetic defect suspected in this
situation?
Plasminogen
Hageman factor
Bradykinin
C1 esterase inhibitor - CORRECT ANS - C1 esterase inhibitor
The parent of a child diagnosed with Down syndrome expresses concerns about the child's recurrent
respiratory tract infections to an advanced practice registered nurse (APRN). The infections have
occurred regularly since birth. What should the APRN tell the parent is the underlying cause of this
illness?
Hyperthyroidism causes an increased risk of infection.
Gastroesophageal reflux disease causes aspiration of thin fluids.
Hypertonia causes airway restriction.
Short stature causes poor lung development. - CORRECT ANS - Gastroesophageal reflux disease
causes aspiration of thin fluids.
A 36-year-old patient is being seen by an advanced practice registered nurse (APRN) in a primary
care clinic for the first time. The patient reports feeling depressed due to a major life change.
Additional symptoms include weight gain, sedentary activity, and insomnia. The APRN plans on
providing the patient with several exercises to reduce the physiological effect of stress. Why is the
APRN concerned about relieving this emotional response?
It increases protein synthesis.
It increases smooth muscle contraction.
It decreases glucose uptake. - CORRECT ANS - It decreases glucose uptake.
An 80-year-old patient brings her grandchildren with her to a routine medical appointment. The
patient has moderate chronic obstructive pulmonary disease (COPD) and is concerned about
developing pneumonia because of its increased incidence at the senior center. What should the nurse
practitioner recommend for this patient?
Avoiding her grandchildren this winter
