FNP 654 Final Exam
A 12-year-old child is brought to the clinic with joint pain, a 3-week history of
low-grade fever, and a facial rash. The primary care nurse practitioner palpates an
enlarged liver 2 cm below the subcostal margin along with diffuse
lymphadenopathy. An ANA test is positive. Which test may be ordered to confirm
a diagnosis of SLE? - ANS Anti-double-strand DNA antibodies
A 13-year-old child has exhibited symptoms of mild depression for several weeks.
The parent reports feeling relieved that the symptoms have passed but
concerned that the child now seems to have boundless energy and an inability to
sit still. What will the primary care nurse practitioner do? - ANS Refer the child
to a child psychiatrist for evaluation of bipolar disorder.
A 14-year-old female comes to the clinic with amenorrhea for 3 months. A
pregnancy test is negative. The adolescent's body weight is at 82% of expected
for height and age. The mother reports that her daughter often throws up and
refuses to eat most foods. Which condition does the primary care nurse
practitioner suspect? - ANS Anorexia nervosa
A 16-year-old female has primary amenorrhea. A pregnancy test is negative.
Further testing reveals a normal TSH and an elevated prolactin level. Which test
will the provider order next? - ANS Magnetic resonance imaging
A 16-year-old patient with primary dysmenorrhea has taken NSAIDs and COX-2
inhibitors without getting relief from symptoms. What will the provider suggest? -
ANS A combined oral contraceptive
A 16-year-old sexually active female has symptoms of PID with fever. Cultures are
pending. For outpatient treatment, what will the provider order? - ANS
Rocephin, doxycycline, and metronidazole
A 17-year-old patient has undergone surgical incision and drainage of a
Bartholin's cyst with insertion of a drain. What is an important aspect of care for
this patient? - ANS Weekly follow-up monitoring
,A 30-year-old male patient has a positive leukocyte esterase and nitrites on a
random urine dipstick during a well patient exam. What type of urinary tract
infection does this represent? - ANS Complicated
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? - ANS Prescribe oral prednisolone
A 35-year-old woman without a previous history of dysmenorrhea reports lower
pelvic pain and irregular bleeding between periods. What is the initial action in
managing this patient? - ANS Performing an abdominal, pelvic, and
rectovaginal examination
A 40-year-old patient with primary hyperparathyroidism has increased serum
calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the
recommended treatment for this patient? - ANS Annual monitoring of calcium,
creatinine, and bone density
A 45-year-old woman has gone 120 days without a menstrual period. A pregnancy
test is negative. What will the provider do, based on this symptom? - ANS
Evaluate for various causes of amenorrhea
A 50-year-old man reports having erectile dysfunction. What is an important
response by the provider when developing a plan of care for this patient? - ANS
Evaluating the patient for cardiovascular disease
A 60-year-old female patient has recently lost weight and a physical examination
reveals a beefy-red, sore tongue, with no neurological findings. Based on these
clinical findings, what will the provider anticipate finding in the laboratory data? -
ANS Low hemoglobin and elevated MCV
A 60-year-old patient reports new onset of bilateral shoulder pain with morning
stiffness lasting approximately one hour. Which will be NOT be included in initial
diagnostic testing for this patient? - ANS Serum Calcitonin
A 67-year-old female patient reports vulvar pruritus and dyspareunia. The
provider notes white papules on the vulva with thinning of the epithelium. What
condition does the provider suspect? - ANS Lichen sclerosis
, A 69-year-old patient with cancer is reluctant to take an opioid agonist medication
because of the side effects. What will the primary care provider recommend? -
ANS Taking a stool softener with the opioid
A child has a fever and arthralgia. The primary care nurse practitioner learns that
the child had a sore throat 3 weeks prior and auscultates a murmur in the clinic.
Which test will the nurse practitioner order? - ANS ASO Titer
A child has a high fever, bilateral conjunctivitis, and a desquamating rash and is
presumed to have a vasculitic disease. What is the likely treatment for this child?
- ANS Aspirin and Intravenous immunoglobulin
A child has plaques on the extensor surfaces of both elbows and on the face with
minimal scaling and pruritis. What is the likely cause of these lesions? - ANS
Psoriasis
A child has vesiculopustular lesions around the nose and mouth with areas of
honey-colored crusts. The provider notes a few similar lesions on the child's
hands and legs. Which treatment is appropriate for this child? - ANS
Amoxicillin-clavulanate
A child is brought to a clinic with a sudden onset of rash after taking an antibiotic
for 2 days. The provider notes all over wheals with pruritis, which the parent
reports seem to come and go. Which action is correct? - ANS Admit the child to
the hospital for treatment and observation
A child who has atopic dermatitis has recurrent secondary bacterial skin
infections. What will the provider recommend to help prevent these infections? -
ANS Bleach baths twice weekly
A complete blood count on a 12-month-old infant reveals microcytic,
hypochromic anemia with a hemoglobin of 9.5 g/dL. The infar has mild pallor with
no hepatosplenomegaly. The family nurse practitioner suspects: - ANS Iron
deficiency anemia
A couple who has been trying to conceive for over 9 months asks the provider
about artificial reproductive therapy. When discussing risks and benefits
associated with these methods, what will the provider include? - ANS Increased
premature births
A 12-year-old child is brought to the clinic with joint pain, a 3-week history of
low-grade fever, and a facial rash. The primary care nurse practitioner palpates an
enlarged liver 2 cm below the subcostal margin along with diffuse
lymphadenopathy. An ANA test is positive. Which test may be ordered to confirm
a diagnosis of SLE? - ANS Anti-double-strand DNA antibodies
A 13-year-old child has exhibited symptoms of mild depression for several weeks.
The parent reports feeling relieved that the symptoms have passed but
concerned that the child now seems to have boundless energy and an inability to
sit still. What will the primary care nurse practitioner do? - ANS Refer the child
to a child psychiatrist for evaluation of bipolar disorder.
A 14-year-old female comes to the clinic with amenorrhea for 3 months. A
pregnancy test is negative. The adolescent's body weight is at 82% of expected
for height and age. The mother reports that her daughter often throws up and
refuses to eat most foods. Which condition does the primary care nurse
practitioner suspect? - ANS Anorexia nervosa
A 16-year-old female has primary amenorrhea. A pregnancy test is negative.
Further testing reveals a normal TSH and an elevated prolactin level. Which test
will the provider order next? - ANS Magnetic resonance imaging
A 16-year-old patient with primary dysmenorrhea has taken NSAIDs and COX-2
inhibitors without getting relief from symptoms. What will the provider suggest? -
ANS A combined oral contraceptive
A 16-year-old sexually active female has symptoms of PID with fever. Cultures are
pending. For outpatient treatment, what will the provider order? - ANS
Rocephin, doxycycline, and metronidazole
A 17-year-old patient has undergone surgical incision and drainage of a
Bartholin's cyst with insertion of a drain. What is an important aspect of care for
this patient? - ANS Weekly follow-up monitoring
,A 30-year-old male patient has a positive leukocyte esterase and nitrites on a
random urine dipstick during a well patient exam. What type of urinary tract
infection does this represent? - ANS Complicated
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? - ANS Prescribe oral prednisolone
A 35-year-old woman without a previous history of dysmenorrhea reports lower
pelvic pain and irregular bleeding between periods. What is the initial action in
managing this patient? - ANS Performing an abdominal, pelvic, and
rectovaginal examination
A 40-year-old patient with primary hyperparathyroidism has increased serum
calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the
recommended treatment for this patient? - ANS Annual monitoring of calcium,
creatinine, and bone density
A 45-year-old woman has gone 120 days without a menstrual period. A pregnancy
test is negative. What will the provider do, based on this symptom? - ANS
Evaluate for various causes of amenorrhea
A 50-year-old man reports having erectile dysfunction. What is an important
response by the provider when developing a plan of care for this patient? - ANS
Evaluating the patient for cardiovascular disease
A 60-year-old female patient has recently lost weight and a physical examination
reveals a beefy-red, sore tongue, with no neurological findings. Based on these
clinical findings, what will the provider anticipate finding in the laboratory data? -
ANS Low hemoglobin and elevated MCV
A 60-year-old patient reports new onset of bilateral shoulder pain with morning
stiffness lasting approximately one hour. Which will be NOT be included in initial
diagnostic testing for this patient? - ANS Serum Calcitonin
A 67-year-old female patient reports vulvar pruritus and dyspareunia. The
provider notes white papules on the vulva with thinning of the epithelium. What
condition does the provider suspect? - ANS Lichen sclerosis
, A 69-year-old patient with cancer is reluctant to take an opioid agonist medication
because of the side effects. What will the primary care provider recommend? -
ANS Taking a stool softener with the opioid
A child has a fever and arthralgia. The primary care nurse practitioner learns that
the child had a sore throat 3 weeks prior and auscultates a murmur in the clinic.
Which test will the nurse practitioner order? - ANS ASO Titer
A child has a high fever, bilateral conjunctivitis, and a desquamating rash and is
presumed to have a vasculitic disease. What is the likely treatment for this child?
- ANS Aspirin and Intravenous immunoglobulin
A child has plaques on the extensor surfaces of both elbows and on the face with
minimal scaling and pruritis. What is the likely cause of these lesions? - ANS
Psoriasis
A child has vesiculopustular lesions around the nose and mouth with areas of
honey-colored crusts. The provider notes a few similar lesions on the child's
hands and legs. Which treatment is appropriate for this child? - ANS
Amoxicillin-clavulanate
A child is brought to a clinic with a sudden onset of rash after taking an antibiotic
for 2 days. The provider notes all over wheals with pruritis, which the parent
reports seem to come and go. Which action is correct? - ANS Admit the child to
the hospital for treatment and observation
A child who has atopic dermatitis has recurrent secondary bacterial skin
infections. What will the provider recommend to help prevent these infections? -
ANS Bleach baths twice weekly
A complete blood count on a 12-month-old infant reveals microcytic,
hypochromic anemia with a hemoglobin of 9.5 g/dL. The infar has mild pallor with
no hepatosplenomegaly. The family nurse practitioner suspects: - ANS Iron
deficiency anemia
A couple who has been trying to conceive for over 9 months asks the provider
about artificial reproductive therapy. When discussing risks and benefits
associated with these methods, what will the provider include? - ANS Increased
premature births
