CEA ADVANCED NURSING PRACTICE
EXAM CORRECT 100%
When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans in
with the right side of his head and frequently asks for things to be repeated. His
daughter is very worried that he has dementia or depression because he has also
become increasingly isolated, as well as increasingly irritable as he believes people are
yelling at him out of frustration of not being heard. The daughter is tearful, anxious, and
frustrated. What should the PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter -
ANSWERExamine the patient's ear canals
A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he had
felt a lump on his left testicle. He is concerned he has not had a physical exam in 10
years. What is the best action by the PMHNP?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology - ANSWERExplore the reason for not having had a physical in so
long
In observing the appearance of the patient with depression and a history of systemic
lupus erythematosus, the PMHNP notices a lesion on the neck of the patient about the
size of a pencil eraser, flush with the skin, uniformly colored, with discrete borders, and
consistent texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology - ANSWERWatch and wait
Which of the following best represent the physical exam maneuver known as Murphy's
sign?
While supine, ask the patient to grasp her knee while tucking 1 leg up to the chest. A
positive test occurs when pain prohibits elevation of the ipsilateral leg.
, The examiner palpates in the right upper abdominal quadrant below the costal margin
while the patient breathes in. The test is positive if the examiner observes pain during
inhalation.
Press and palpate deeply into the abdomen and release quickly observing for pain.
Ask the patient to bend at the knees while holding onto a rail, observe for a loss of
balance. - ANSWERThe examiner palpates in the right upper abdominal quadrant
below the costal margin while the patient breathes in. The test is positive if the examiner
observes pain during inhalation.
Acute cholecystitis
What does the Murphy sign assess for - ANSWERCholecystitis
A 26-year-old man has been on an antipsychotic. He requires further titration for control
of symptoms. Which of the following tests should be repeated?
EKG
Head CT scan
Liver function test
Urinalysis - ANSWEREKG
Your client Jamie asks you about a mole of her forearm. You refer her to dermatology.
As an APRN, you recognize that cancerous moles can be detected on exam. Which of
the following would not be of concern?
A mole that is not elevated
A mole that is 5 mm in size
All of the above
A dark mole - ANSWERAll of the above
Recall the ABCDE acronym. Concerning moles - ANSWERasymmetric, have irregular
borders, have color variation, a diameter > 6mm and elevated moles.
Which of the following would be considered a risk factor for melanoma?
Female gender
A history of melanoma
A mole with symmetrical borders
A dark covered mole approximately 5mm in size - ANSWERA history of melanoma
Gloria is a 68-year-old female with a chronic history of severe anxiety disorder presents
with mild shortness of breath, fine crackles in the right lower lobe with auscultation and
a nonproductive cough. She recently "ran out of pills". Which medication omission most
likely lead to her current presenting symptoms?
Metoprolol
Lorazepam
EXAM CORRECT 100%
When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans in
with the right side of his head and frequently asks for things to be repeated. His
daughter is very worried that he has dementia or depression because he has also
become increasingly isolated, as well as increasingly irritable as he believes people are
yelling at him out of frustration of not being heard. The daughter is tearful, anxious, and
frustrated. What should the PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter -
ANSWERExamine the patient's ear canals
A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he had
felt a lump on his left testicle. He is concerned he has not had a physical exam in 10
years. What is the best action by the PMHNP?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology - ANSWERExplore the reason for not having had a physical in so
long
In observing the appearance of the patient with depression and a history of systemic
lupus erythematosus, the PMHNP notices a lesion on the neck of the patient about the
size of a pencil eraser, flush with the skin, uniformly colored, with discrete borders, and
consistent texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology - ANSWERWatch and wait
Which of the following best represent the physical exam maneuver known as Murphy's
sign?
While supine, ask the patient to grasp her knee while tucking 1 leg up to the chest. A
positive test occurs when pain prohibits elevation of the ipsilateral leg.
, The examiner palpates in the right upper abdominal quadrant below the costal margin
while the patient breathes in. The test is positive if the examiner observes pain during
inhalation.
Press and palpate deeply into the abdomen and release quickly observing for pain.
Ask the patient to bend at the knees while holding onto a rail, observe for a loss of
balance. - ANSWERThe examiner palpates in the right upper abdominal quadrant
below the costal margin while the patient breathes in. The test is positive if the examiner
observes pain during inhalation.
Acute cholecystitis
What does the Murphy sign assess for - ANSWERCholecystitis
A 26-year-old man has been on an antipsychotic. He requires further titration for control
of symptoms. Which of the following tests should be repeated?
EKG
Head CT scan
Liver function test
Urinalysis - ANSWEREKG
Your client Jamie asks you about a mole of her forearm. You refer her to dermatology.
As an APRN, you recognize that cancerous moles can be detected on exam. Which of
the following would not be of concern?
A mole that is not elevated
A mole that is 5 mm in size
All of the above
A dark mole - ANSWERAll of the above
Recall the ABCDE acronym. Concerning moles - ANSWERasymmetric, have irregular
borders, have color variation, a diameter > 6mm and elevated moles.
Which of the following would be considered a risk factor for melanoma?
Female gender
A history of melanoma
A mole with symmetrical borders
A dark covered mole approximately 5mm in size - ANSWERA history of melanoma
Gloria is a 68-year-old female with a chronic history of severe anxiety disorder presents
with mild shortness of breath, fine crackles in the right lower lobe with auscultation and
a nonproductive cough. She recently "ran out of pills". Which medication omission most
likely lead to her current presenting symptoms?
Metoprolol
Lorazepam
