NR509 Final Exam Study Guide | Actual Exam
Questions &Answers & Review |Well Rationalized
and Revised |Frequently Most Tested Questions
and 100% Accurate | High Yield Questions and
Answers | Newest Exam and Latest Version!!!
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
A 24-year-old female presents to the clinic for an annual exam. The NP proceeds
to perform a Pap smear and understands that the most important area on the
cervix to obtain cells for the Pap smear is where?
ANSWER:<< Transformation zone
A 45-year-old female presents to the clinic for heavy periods and pelvic pain
during her menses. She reached menarche at age 13 years and has had regular
periods except during her pregnancies. She is a G4P3013 and does not use birth
control as her husband has had a vasectomy. She states this has been going on
for about a year but seems to be getting worse. Her LMP was 1 week ago. On a
bimanual exam, a large midline mass halfway to the umbilicus is palpated. Each
adnexal area is nonpalpable. Her rectal exam is normal. Her body mass index
(BMI) is 27. Which of the following is the most likely interpretation of these
findings?
ANSWER:<< These findings suggest uterine fibroids
A 48-year-old female presents to the clinic with complaints of heavy vaginal
discharge and severe itching for 1 week. On visualization of the vulva, a thick,
,white, curdy discharge is seen at the introitus. On speculum examination, there
is a copious amount of this discharge. The pH of the discharge is 4.1 and the
KOH whiff test is negative, with no unusual smell. Wet prep shows budding
hyphae. Which of the following is the most accurate interpretation of these
findings?
ANSWER:<< These findings suggest candida vaginitis
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 development?
ANSWER:<< IV
Primary prevention is defined as which of the following?
ANSWER:<< Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations,
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.
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
mortality.
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).
,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."
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
Which cranial nerve (CN) innervates the muscles of the pharynx and provides
sensory fibers to portions of the tympanic membrane, auditory canal, pharynx,
and the posterior third of the tongue?
ANSWER:<< CN IX
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
Which of the following statements is true regarding risks and rapid recognition
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
The combination of both receptive and expressive aphasia is a characteristic of
which type of speech disorder?
ANSWER:<< global aphasia
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?
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.
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
Which musculoskeletal disorder is paired correctly with the associated systemic
manifestations?
ANSWER:<< Lyme disease and expanding erythematous targetoid patch in early
illness
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the
following are expected assessment findings consistent with the diagnosis?
ANSWER:<< Swelling of the synovial tissue in joints and tendon sheaths.
A 58-year-old male complains of pain in his knees, hips, hands, wrists, neck, and
lower back. Based on the joints involved, the NP suspects that the patient most
likely has which condition?
ANSWER:<< Osteoarthritis
A 55-year-old male has a diagnosis of lumbar spinal stenosis. Which sign should
the NP expect to find on examination that is most consistent with the diagnosis?
ANSWER:<< Flexed forward posture with lower extremity weakness
What is the action(s) of the erector spinae muscle group?
ANSWER:<< Extension of the spine
A 17-year-old male presents to the clinic for a follow-up appointment. He
fractured his left arm 8 weeks ago and remains in a cast. Upon inspection, the
NP finds that his shoulder heights are unequal and there is winging of the
scapula. The NP suspects contralateral weakness and muscle wasting as the
etiology for the winged scapula. Which of the following physical assessment
maneuvers should the NP perform to confirm the suspension?
ANSWER:<< Compare the strength of the trapezius muscles
A 31-year-old female presents to the clinic with a worsening stiff, painful neck.
On inspection, the patient's head is laterally deviated toward the shoulder and
rotated. Given this specific physical assessment finding, what condition should
the NP suspect as a differential diagnosis?
ANSWER:<< Torticollis
Questions &Answers & Review |Well Rationalized
and Revised |Frequently Most Tested Questions
and 100% Accurate | High Yield Questions and
Answers | Newest Exam and Latest Version!!!
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
A 24-year-old female presents to the clinic for an annual exam. The NP proceeds
to perform a Pap smear and understands that the most important area on the
cervix to obtain cells for the Pap smear is where?
ANSWER:<< Transformation zone
A 45-year-old female presents to the clinic for heavy periods and pelvic pain
during her menses. She reached menarche at age 13 years and has had regular
periods except during her pregnancies. She is a G4P3013 and does not use birth
control as her husband has had a vasectomy. She states this has been going on
for about a year but seems to be getting worse. Her LMP was 1 week ago. On a
bimanual exam, a large midline mass halfway to the umbilicus is palpated. Each
adnexal area is nonpalpable. Her rectal exam is normal. Her body mass index
(BMI) is 27. Which of the following is the most likely interpretation of these
findings?
ANSWER:<< These findings suggest uterine fibroids
A 48-year-old female presents to the clinic with complaints of heavy vaginal
discharge and severe itching for 1 week. On visualization of the vulva, a thick,
,white, curdy discharge is seen at the introitus. On speculum examination, there
is a copious amount of this discharge. The pH of the discharge is 4.1 and the
KOH whiff test is negative, with no unusual smell. Wet prep shows budding
hyphae. Which of the following is the most accurate interpretation of these
findings?
ANSWER:<< These findings suggest candida vaginitis
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 development?
ANSWER:<< IV
Primary prevention is defined as which of the following?
ANSWER:<< Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations,
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.
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
mortality.
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).
,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."
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
Which cranial nerve (CN) innervates the muscles of the pharynx and provides
sensory fibers to portions of the tympanic membrane, auditory canal, pharynx,
and the posterior third of the tongue?
ANSWER:<< CN IX
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
Which of the following statements is true regarding risks and rapid recognition
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
The combination of both receptive and expressive aphasia is a characteristic of
which type of speech disorder?
ANSWER:<< global aphasia
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?
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.
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
Which musculoskeletal disorder is paired correctly with the associated systemic
manifestations?
ANSWER:<< Lyme disease and expanding erythematous targetoid patch in early
illness
A 62-year-old female has a diagnosis of rheumatoid arthritis (RA). Which of the
following are expected assessment findings consistent with the diagnosis?
ANSWER:<< Swelling of the synovial tissue in joints and tendon sheaths.
A 58-year-old male complains of pain in his knees, hips, hands, wrists, neck, and
lower back. Based on the joints involved, the NP suspects that the patient most
likely has which condition?
ANSWER:<< Osteoarthritis
A 55-year-old male has a diagnosis of lumbar spinal stenosis. Which sign should
the NP expect to find on examination that is most consistent with the diagnosis?
ANSWER:<< Flexed forward posture with lower extremity weakness
What is the action(s) of the erector spinae muscle group?
ANSWER:<< Extension of the spine
A 17-year-old male presents to the clinic for a follow-up appointment. He
fractured his left arm 8 weeks ago and remains in a cast. Upon inspection, the
NP finds that his shoulder heights are unequal and there is winging of the
scapula. The NP suspects contralateral weakness and muscle wasting as the
etiology for the winged scapula. Which of the following physical assessment
maneuvers should the NP perform to confirm the suspension?
ANSWER:<< Compare the strength of the trapezius muscles
A 31-year-old female presents to the clinic with a worsening stiff, painful neck.
On inspection, the patient's head is laterally deviated toward the shoulder and
rotated. Given this specific physical assessment finding, what condition should
the NP suspect as a differential diagnosis?
ANSWER:<< Torticollis
