FNP 654 FINAL EXAM
3. A patient has type 1 Von Willebrand disease (vWD). What treatment is generally
effective to prevent and treat bleeding episodes in this patient? - ANS>
Desmopressin
A 15-year-old female who participates in high school track and gymnastics is
experiencing amenorrhea after having eight normal periods. A pregnancy test is
negative. What may be included in management of this patient's amenorrhea to
restore normal periods?
Select all that apply. - ANS> Calcium and vitamin D supplementation
Dietician consultation
Estriol therapy
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 17-year-old male is brought to the clinic by a parent who is concerned that the
patient has become more isolated and withdrawn and expresses suspicions that
his teachers hate him and want him to fail. What will the provider tell this parent?
- ANS> The adolescent should be evaluated by a psychiatrist.
A 20 kg child has iron-deficiency anemia and will begin taking an oral iron
preparation. What will the provider teach the child's parents about administration
of this medication? - ANS> The correct dose is 30 mg twice daily.
A 3-year-old child has marked pain in one leg localized to the upper tibia with
refusal to bear weight. The child has a high fever and a toxic appearance. Which
type of osteomyelitis is most likely? - ANS> Hematogenous osteomyelitis
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 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 30-year-old male patient is diagnosed with Hodgkin lymphoma. Initial lab work
reveals a WBC of 20 × 109/L, hemoglobin of 10.1 gm/dL, a serum albumin of 45
gm/dL, and lymphopenia of 0.5 × 109/L. Staging studies identify stage III disease.
What is this patient's prognostic score? - ANS> 4
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 patient has mild osteoarthritis in both knees and asks about
non-pharmacologic therapies. What will the provider recommend? - ANS>
Aerobic exercise
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 50-year-old patient with diabetes mellitus has a low-grade fever and pain on
one foot. The provider notes erythema and swelling at the site along with several
superficial skin ulcers without necrosis and suspects osteomyelitis. Which type
of diagnostic study will the provider order? - ANS> Plain radiograph of the foot
,A 50-year-old woman reports pain in one knee upon awakening each morning that
goes away later in the morning. A knee radiograph is negative for pathology and
serum inflammatory markers are normal. What will the provider tell this patient? -
ANS> To take acetaminophen 1 gram three times daily for pain
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 included in initial
diagnostic testing for this patient?
Select all that apply. - ANS> ESR and CRP
Liver function tests
Protein electrophoresis
A 70-year-old patient reports frequent infections, shortness of breath, fatigue, and
palpitations. An exam reveals pallor and petechiae. The provider orders a
peripheral blood smear and bone marrow biopsy. Which findings are consistent
with a diagnosis of myelodysplasia?
Select all that apply. - ANS> Anisocytosis and poikilocytosis of erythrocytes on
peripheral smear
Defects in cellular maturation in all cell lines in bone marrow aspirate
Hypercellular bone marrow with peripheral cytopenia
Larger than normal megakaryocytes in bone marrow
A child experiences a snake bite while camping and is seen in the emergency
department. The child's parents are not able to identify the type of snake. An
inspection of the site reveals two puncture wounds on the child's arm with no
swelling or erythema at the site. The child has normal vital signs. Which
treatment is indicated? - ANS> Cleaning the wound, giving tetanus prophylaxis,
and observing for 12 hours
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 a recent history of leg pain, unexplained bruising, and nosebleeds.
The provider notes petechiae and diffuse lymphadenopathy. A complete blood
, count reveals a WBC of 30,000 cells/mm3 and near normal RBC and platelet
counts. What will the provider do next to manage this patient? - ANS> Refer to a
specialist for a bone marrow aspirate and biopsy
A child has irritant contact dermatitis with lesions on the extremities and face.
Which treatment is recommended for this patient? - ANS> Oral corticosteroids
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 is brought to the emergency department after getting lost while camping
on a cold, rainy day. The child is lethargic on admission. The cardiorespiratory
monitor shows a normal heart rate and rhythm, a respiratory rate of 8 to 10
breaths per minute, and a normal blood pressure. The assessment reveals
erythema and edema of the child's hands and feet. What treatments are
indicated?
Select all that apply. - ANS> Apply warmed blankets
Elevate the child's extremities
Remove all clothing
A child is brought to the emergency department because a grandparent suspects
ingestion of a tricyclic antidepressant medication found in the bathroom. What
symptoms will the ED professionals expect to observe if this is the case?
Select all that apply. - ANS> Flushed skin
Hallucinations
Mydriasis
3. A patient has type 1 Von Willebrand disease (vWD). What treatment is generally
effective to prevent and treat bleeding episodes in this patient? - ANS>
Desmopressin
A 15-year-old female who participates in high school track and gymnastics is
experiencing amenorrhea after having eight normal periods. A pregnancy test is
negative. What may be included in management of this patient's amenorrhea to
restore normal periods?
Select all that apply. - ANS> Calcium and vitamin D supplementation
Dietician consultation
Estriol therapy
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 17-year-old male is brought to the clinic by a parent who is concerned that the
patient has become more isolated and withdrawn and expresses suspicions that
his teachers hate him and want him to fail. What will the provider tell this parent?
- ANS> The adolescent should be evaluated by a psychiatrist.
A 20 kg child has iron-deficiency anemia and will begin taking an oral iron
preparation. What will the provider teach the child's parents about administration
of this medication? - ANS> The correct dose is 30 mg twice daily.
A 3-year-old child has marked pain in one leg localized to the upper tibia with
refusal to bear weight. The child has a high fever and a toxic appearance. Which
type of osteomyelitis is most likely? - ANS> Hematogenous osteomyelitis
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 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 30-year-old male patient is diagnosed with Hodgkin lymphoma. Initial lab work
reveals a WBC of 20 × 109/L, hemoglobin of 10.1 gm/dL, a serum albumin of 45
gm/dL, and lymphopenia of 0.5 × 109/L. Staging studies identify stage III disease.
What is this patient's prognostic score? - ANS> 4
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 patient has mild osteoarthritis in both knees and asks about
non-pharmacologic therapies. What will the provider recommend? - ANS>
Aerobic exercise
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 50-year-old patient with diabetes mellitus has a low-grade fever and pain on
one foot. The provider notes erythema and swelling at the site along with several
superficial skin ulcers without necrosis and suspects osteomyelitis. Which type
of diagnostic study will the provider order? - ANS> Plain radiograph of the foot
,A 50-year-old woman reports pain in one knee upon awakening each morning that
goes away later in the morning. A knee radiograph is negative for pathology and
serum inflammatory markers are normal. What will the provider tell this patient? -
ANS> To take acetaminophen 1 gram three times daily for pain
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 included in initial
diagnostic testing for this patient?
Select all that apply. - ANS> ESR and CRP
Liver function tests
Protein electrophoresis
A 70-year-old patient reports frequent infections, shortness of breath, fatigue, and
palpitations. An exam reveals pallor and petechiae. The provider orders a
peripheral blood smear and bone marrow biopsy. Which findings are consistent
with a diagnosis of myelodysplasia?
Select all that apply. - ANS> Anisocytosis and poikilocytosis of erythrocytes on
peripheral smear
Defects in cellular maturation in all cell lines in bone marrow aspirate
Hypercellular bone marrow with peripheral cytopenia
Larger than normal megakaryocytes in bone marrow
A child experiences a snake bite while camping and is seen in the emergency
department. The child's parents are not able to identify the type of snake. An
inspection of the site reveals two puncture wounds on the child's arm with no
swelling or erythema at the site. The child has normal vital signs. Which
treatment is indicated? - ANS> Cleaning the wound, giving tetanus prophylaxis,
and observing for 12 hours
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 a recent history of leg pain, unexplained bruising, and nosebleeds.
The provider notes petechiae and diffuse lymphadenopathy. A complete blood
, count reveals a WBC of 30,000 cells/mm3 and near normal RBC and platelet
counts. What will the provider do next to manage this patient? - ANS> Refer to a
specialist for a bone marrow aspirate and biopsy
A child has irritant contact dermatitis with lesions on the extremities and face.
Which treatment is recommended for this patient? - ANS> Oral corticosteroids
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 is brought to the emergency department after getting lost while camping
on a cold, rainy day. The child is lethargic on admission. The cardiorespiratory
monitor shows a normal heart rate and rhythm, a respiratory rate of 8 to 10
breaths per minute, and a normal blood pressure. The assessment reveals
erythema and edema of the child's hands and feet. What treatments are
indicated?
Select all that apply. - ANS> Apply warmed blankets
Elevate the child's extremities
Remove all clothing
A child is brought to the emergency department because a grandparent suspects
ingestion of a tricyclic antidepressant medication found in the bathroom. What
symptoms will the ED professionals expect to observe if this is the case?
Select all that apply. - ANS> Flushed skin
Hallucinations
Mydriasis
