An advanced practice registered nurse (APRN) is consulting with a teen patient who has re-
cently 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 con-
cern.
Which medication is the APRN concerned about? - ANSWER 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 dis-
ease.
Which question should the APRN ask? - ANSWER "Are you both the genetic donor par-
ents?"
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? - AN-
SWER 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 sev-
eral days. The patient does not have complaints of fever, hives, or vomiting. Serum lab re-
sults show hyperactivation of three plasma protein systems. The APRN suspects hereditary
angioedema.
What is the cause of the genetic defect suspected in this situation? - ANSWER C1 es-
terase inhibitor
1
, 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? - AN-
SWER 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 pri-
mary 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? - ANSWER It de-
creases 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? - ANSWER Getting an
annual influenza vaccine
An advanced practice nurse (APRN) is working with a patient who is choosing to undergo
breast removal due to family history of breast cancer. The patient's genetic testing revealed
an abnormal BRCA1. The patient shares with the APRN that she is relieved that she will not
need to worry about cancer once the breast tissue is removed. The APRN proceeds to edu-
cate the patient about additional risks.
Which other type of cancer is the patient at risk for developing? - ANSWER Ovarian
A patient presents to the hospital complaining of blurred vision, muscle weaknesses, im-
paired 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 assess-
ment reveals a diagnosis of multiple sclerosis.
2
cently 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 con-
cern.
Which medication is the APRN concerned about? - ANSWER 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 dis-
ease.
Which question should the APRN ask? - ANSWER "Are you both the genetic donor par-
ents?"
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? - AN-
SWER 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 sev-
eral days. The patient does not have complaints of fever, hives, or vomiting. Serum lab re-
sults show hyperactivation of three plasma protein systems. The APRN suspects hereditary
angioedema.
What is the cause of the genetic defect suspected in this situation? - ANSWER C1 es-
terase inhibitor
1
, 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? - AN-
SWER 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 pri-
mary 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? - ANSWER It de-
creases 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? - ANSWER Getting an
annual influenza vaccine
An advanced practice nurse (APRN) is working with a patient who is choosing to undergo
breast removal due to family history of breast cancer. The patient's genetic testing revealed
an abnormal BRCA1. The patient shares with the APRN that she is relieved that she will not
need to worry about cancer once the breast tissue is removed. The APRN proceeds to edu-
cate the patient about additional risks.
Which other type of cancer is the patient at risk for developing? - ANSWER Ovarian
A patient presents to the hospital complaining of blurred vision, muscle weaknesses, im-
paired 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 assess-
ment reveals a diagnosis of multiple sclerosis.
2
