NRNP 6531 Prim Care of Adults Final Exam

NRNP 6531 Prim Care of Adults Final Exam

Question 1

A 72 year old female presents with complaints of dyspnea with exertion, mild exertional chest pain and presyncope. Her exam reveals a harsh 3/6 late peaking systolic murmur heard loudest at the right sternal border that radiates to the carotids. Which condition is suspected?

A) Aortic stenosis

B) Hypertrophic cardiomyopathy

C) Mitral regurgitation

D) Mitral valve prolapse

Question 2

A 70 year old male patient with heart failure for 18 months, reports being comfortable while at rest but experiences palpitations and dyspnea when walking to the mailbox. Which classification of heart failure is appropriate based on these symptoms?

A) Class I

B) Class II

C) Class III

D) Class IV

Question 3

Heart failure patients with a lower ejection fraction will have which symptoms?

A) Fatigue and dyspnea without volume overload

B) Impairment of ventricular filling and relaxation

C) Exertionally related, mild dyspnea

D) Left ventricular systolic dysfunction causing pump failure

Question 4

A patient diagnosed with atopic dermatitis asks what can be done to minimize the recurrence of symptoms. What will the provider recommend?

A) Calcineurin inhibitors

B) Lubricants and emollients

C) Oral diphenhydramine

D) Prophylactic topical steroids

Question 5

A patient sustains chemical burns on both arms after a spill at work. What is the initial action by the health care providers in the emergency department (ED)?

A) Begin aggressive irrigation of the site.

B) Contact the poison control center.

C) Remove the offending chemical and garments.

D) Request the Material Safety Data information.

Question 6

A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection?

A) Amoxicillin-clavulanate

B) Clindamycin

C) Doxycycline

D) Sulfamethoxazole-trimethoprim

Question 7

Which protective precaution is especially important in a metal fabrication workshop?

A) 2 mm polycarbonate safety glasses

B) Eyewash stations

C) Glasses with UVB protection

D) Polycarbonate goggles

Question 8

A 61 year old patient sustains an ocular injury in which a shard of glass from a bottle penetrated the eye wall. The emergency department provider notes that the shard has remained in the eye. Which term best describes this type of injury?

A) Intraocular foreign body

B) Penetrating eye injury

C) Perforating eye injury

D) Ruptured globe injury

Question 9

During a routine physical examination, a provider notes a shiny, irregular, painless lesion on the top of one ear auricle and suspects skin cancer. What will the provider tell the patient about this lesion?

A) A biopsy should be performed.

B) Immediate surgery is recommended.

C) It is benign and will not need intervention.

D) This is most likely malignant.

Question 10

A female patient who is from the Middle East schedules an appointment in a primary care office. To provide culturally responsive care, what will the clinic personnel do when meeting this patient for the first time?

A)Ensure that she is seen by a female provider.

B) Include a male family member in discussions about health care.

C) Inquire about the patient’s beliefs about health and treatment.

D) Research Middle Eastern cultural beliefs about health care.

More NRNP 6531 Prim Care of Adults Exam Questions

Question 11

A patient expresses concern that she is at risk for breast cancer. To best assess the risk for this patient, what is the best initial action?

A) Ask if there is a family history of breast cancer.

B) Gather and record a three-generation pedigree.

C) Order a genetic test for the breast cancer gene.

D) Recommend direct-to-consumer genetic testing.

Question 12

What is an important part of patient care that can minimize the risk of a formal patient complaint even when a mistake is made?

A) Ensuring informed consent for all procedures

B) Maintaining effective patient communication

C) Monitoring patient compliance and adherence

D) Providing complete documentation of visits

Question 13

A young, previously healthy adult clinic patient reports symptoms of pneumonia including high fever and cough. Auscultation reveals rales in the left lower lobe. A chest radiograph is normal. The patient is unable to expectorate sputum. Which treatment is recommended for this patient?

A) A B-lactam antibiotic plus a fluoroquinolone

B) A respiratory fluoroquinolone antibiotic

C) Empirical treatment with a macrolide antibiotic

D) Hospitalization for intravenous antibiotics

Question 14

A patient presents with a cough and fever. The NP auscultates rales in both lungs that do not clear with cough. The patient reports having a headache and sore throat prior to the onset of coughing. A chest radiograph shows patchy, nonhomogeneous infiltrates. Based on these findings, which organism is the most likely cause of this patient’s pneumonia?

A) A virus

B) Mycoplasma

C) Pneumoniae

D) Tuberculosis

Question 15

An 18 year old patient who has undergone surgical immobilization for a femur fracture two weeks ago, reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism (PE)?

A) Arterial blood gases (ABGs)

B) Computed tomography (CT) angiography

C) D-dimer

D) Electrocardiogram (ECG)

Question 16

36 year old Judy who is asymptomatic tests positive for the hepatitis C virus (HVC). What will the nurse practitioner tell the patient about managing this illness?

A) A rapidly fulminant disease ending with cirrhosis is likely.

B) Administering immunoglobulins helps shorten the course.

C) Several medications are available based on the type of hepatitis C.

D) Treatment is supportive since the infection is self-limiting.

Question 17

A  27 year old patient recovering from chronic alcohol abuse reports nausea, vomiting, diarrhea, and abdominal discomfort. A physical examination is negative for jaundice or ascites. What will the nurse practitioner do initially?

A) Obtain a bilirubin level and prothrombin time

B) Order a complete blood count and liver function tests

C) Reassure the patient that this is likely a viral gastroenteritis

D) Refer the patient to a specialist for evaluation and treatment

Question 18

54 year old John is diagnosed with mild to moderate ulcerative colitis. Which medication will be prescribed initially to establish remission?

A) Azathioprine

B) Budesonide

C) Infliximab

D) Sulfasalazine

Question 19

All of the following are secondary causes of hyperlipidemia except:

A) Diabetes

B) Obesity

C) Smoking

D) Age

Question 20

What is the most important role of the primary care provider in cancer management?

A) Counseling about healthy practices to reduce risk factors

B) Performing regular screenings to detect cancer

C) Referring patients for genetic testing to identify those at risk

D) Teaching patients about cancer management once diagnosed

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Question 21

Anyone who has dementia should have a vitamin B12 level checked.

A) True

B) False

Question 22

A patient diagnosed with myelodysplastic syndrome (MDS) and presenting with severe neutropenia and anemia is given erythropoietin (EPO) with improvement in hemoglobin. Which intervention has been shown to prevent infection in patients with MDS who have severe neutropenia?

A) Anti-thymocyte globulin and cyclosporine

B) Granulocyte-macrophage colony-stimulating factor (GM-CSF)

C) Intravenous immunoglobulin infusions

D) Prophylactic treatment with fluoroquinolones

Question 23

A patient has type 1 Von Willebrand disease (vWD). What treatment is generally effective to prevent and treat bleeding episodes in this patient?

A) Coagulation factor

B) Desmopressin

C) Heparin

D) Vitamin K

Question 24

What is the purpose of radiation treatment prior to surgical resection of a tumor?

A) To debulk the tumor mass

B) To minimize local recurrence

C) To prevent metastases

D) To reduce pain and bleeding

Question 25

Pernicious anemia results in all of the following except:

A) Vitamin B12 deficiency

B) Macrocytic anemia

C) Neurologic symptoms

D) Vitamin D deficiency

Question 26

A 62-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?

A) Decreased homocysteine levels

B) Leukopenia and thrombocytopenia

C) Low hemoglobin and elevated MCV

D) Normal methylmalonic acid level

Question 27

Eileen is a 43 y/o female who comes to your clinic with a chief complaint of “fatigue. “During the HPI she tells The NP that she is no longer able to walk a couple of blocks with her neighbor. She states that she feels her heart “racing” at times; she sometimes feels dizzy, and often has notices that her breathing increases. This has been going on for a month. The NP draws some stat labs on her and the results are as follows: Hgb is 8.4, HCT is 33, RBCs are 3.7 and MCV is 68. The NP diagnoses her as having

A) Normocytic anemia

B) Microcytic anemia

C) Macrocytic anemia

D) None of the above

Question 28

Isabella is suspected of having leukemia and the provider orders biochemical studies and a bone marrow aspirate and biopsy. The results include white blood cells (WBCs) greater than 200,000 cells/mm3 normal red blood cells (RBCs), hyperplastic myeloid cells, and the absence of serum leukocyte alkaline phosphatase. Which test will the provider order to confirm a diagnosis in this patient?

A) Chest radiograph

B) Coagulation studies

C) Philadelphia chromosome test

D) Serum protein electrophoresis

Question 29

Which of the following Ethnic Groups are prone to Thalassemia Minor?

1. Mediterranean
2. North Africa
3. Middle East
4. Southeast Asia
5. All the Above
6. A, C and D only

 

Question 30

All of the following would be appropriate tests for diagnosing anemia except:

A) RBC

B) MCV

C) WBC

D) RDW

Question 31

A male patient has a history of recurrent epistaxis. Prior to a scheduled surgery, the provider asks about a family history of bleeding disorders. The patient reports no female relatives who had excessive bleeding episodes, but states that a maternal uncle and his maternal grandfather both had postsurgical complications related to bleeding. Based on this history, which diagnosis is possible?

A) Hemophilia

B) Thrombocytopenia

C) Thrombophilia

D) Von Willebrand disease

Question 32

Andrew is a 20 y/o African American male who comes to the clinic with the following presentation. His BMI is 47. His PMH indicates hypertension, hyperlipidemia, and acanthosis nigricans. Based on his PMH and presenting symptoms the NP would most likely be inclined to identify him as having:

A) Pheochromocytoma

B) Type 1 Diabetes Mellitus

C) Type 2 diabetes

D) None of the above

Question 33

The diagnostic criteria for metabolic syndrome in men include all of the following except:

A) Waist circumference of 40 inches or more

B) HDL Cholesterol of 50 mg/dL or higher

C) Serum triglycerides of 150mg/dL or higher

D) BP of 130/85 or greater

Question 34

Normocytic anemia has a Mean Corpuscular Volume (MCV) of:

A) <80 fL

B) 80-100 fL

C) >100 fL

D) None of the above

Question 35

A patient has low serum calcium associated with low serum albumin. What is the recommended treatment for this patient?

A) Calcium supplementation only

B) Correction of other serum electrolytes

C) Thiazide diuretics and sodium restriction

D) Vitamin D and calcium supplementation

Question 36

During pregnancy Free T3 and Free T4 are not changed by TSH.

A) True

B) False

Question 371 

Type 1 Diabetes Mellitus is the result of insulin resistance.

A) True

B) False

Question 38

2021 ADA guidelines set HgbA1c goals for most diabetic adults should be:

A) <6.5%

B) 7.5%

C) <7.0%

D) < 6%

Question 39

A patient with normal renal function has a potassium level of 6.0 mEq/L. Which underlying cause is possible in this patient?

A) Adrenocortical deficiency

B) Alcoholism

C) Hypertension

D) Malabsorption syndrome

Question 40

A patient diagnosed with type 2 diabetes mellitus becomes insulin dependent after a year of therapy with oral diabetes medications. When explaining this change in therapy, the provider will tell the patient

A) it is necessary because the patient cannot comply with the previous regimen.

B) that strict diet and exercise measures may be relaxed with insulin therapy.

C) the use of insulin therapy may be temporary.

D) this is because of the natural progression of the disease.

Question 41

All of the following are signs and symptoms of Hypothyroidism except:

A) Rapid speech

B) Fatigue

C) Constipation

D) Bradycardia

Question 42

A patient experiences a carpal spasm when a blood pressure cuff is inflated. Which diagnostic testing will the provider consider evaluating to determine the cause of this finding?

A) Calcitriol level

B) C-reactive protein

C) Magnesium and vitamin D

D) Protein electrophoresis

Question 43

The typical ratio of basal to bolus insulin is:

A) 70:30 or 55:45

B) 50:50 or 60:40

C) 40:60 to 45:55

None of the Above

Question 44

A patient has a serum potassium level of 3 mEq/L and a normal blood pressure. Which test should be performed initially to assist with the differential diagnosis?

A) Plasma aldosterone

B) Plasma renin activity

C) Serum bicarbonate

D) Serum magnesium

Question 45

Lifestyle interventions that result in weight loss and increased physical activity can prevent or delay Type 2 DM.

Group of answer choices

A) True

B) False

Question 46

Type II Diabetes would include which of the following differential diagnoses?

A) Pancreatitis

B) Cushing’s Syndrome

C) Pheochromocytosis

D) All of the Above

Question 47

Migraine Headaches are characterized by all the following symptoms except:

A) Last 4 hours to 3 days

B) Occur 1-3 times/month

C) Always accompanied by an aura

D) Hyper excitable cortical neurons

Question 48

An elderly patient is brought to the emergency department after being found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient’s blood pressure is 220/190 mm Hg. What is the likely treatment for this patient?

A) Carotid endarterectomy

B) Close observation until symptoms resolve

C) Neurosurgical consultation

D) Thrombolytic therapy

Question 49

Migraine headaches involve moderate to severe bilateral pain.

Gwer choices

True

False

Question 50

Migraine headaches would fall under which general category?

A) Tension

B) Muscular

C) Vascular

D) Traction

Question 51

An elderly patient has symptoms of depression and the patient’s daughter asks about possible Alzheimer’s disease (AD) since there is a family history of this disease. A screening evaluation shows no memory loss. What is the initial step in managing this patient?

A) Order brain imaging studies such as CT or MRI.

B) Perform genetic testing to identify true risk.

C) Prescribe a trial of an antidepressant medication.

D) Recommend a trial of a cholinesterase inhibitor drug.

Question 52

A previously lucid patient with early-stage Alzheimer’s disease is hospitalized after a surgical procedure and exhibits distractibility and perceptual disturbances that occur only in the late afternoon. The patient has difficulty sleeping at night and instead sleeps much of the morning. What is the likely cause of these symptoms?

A) Hyperactive delirium

B) Hypoactive delirium

C) Sundowner syndrome

D) Worsening dementia

Question 53

Mike comes in with some nondescript neurological complaints. During your physical exam you notice that he has a loss of his Achilles tendon reflex. This most likely indicates a lesion at what level:

A) L4 to S2

B) L3 to L5

C) L5 to S1

D)None of the above

Question 54

A patient with dementia experiences agitation and visual hallucinations and is given haloperidol with a subsequent worsening of symptoms. Based on this response, what is the likely cause of this patient’s symptoms?

A) Alzheimer’s disease

B) Lewy body dementia

C) Pseudodementia

D) Vascular neurocognitive disorder

Question 55

An 80-year-old patient becomes apathetic, with decreased alertness and a slowing of speech several days after hip replacement surgery alternating with long periods of lucidity. What is the most likely cause of these symptoms?

A) Anesthesia effects

B) Delirium

C) Pain medications

D) Stroke

Question 56

The piriformis syndrome of sciatica is most common in athletes (runners and cyclists).

A) True

B) False

Question 57

Gary is a 78 y/o male who comes to the clinic with an acute headache that is located along his temple. He sometimes has jaw claudication and complains of transient loss of vision. Based on these symptoms the diagnosis is:

A) Temporal Arteritis

B) Trigeminal Neuralgia

C) Transient Ischemic Attack

D) Bell’s Palsy

Question 58

What is recommended to prevent ophthalmic complications in patients with Bell’s palsy?

A)Acupuncture

B) Lubricating eye drops

C) Patching of the eye

D) Sunglasses

Question 59

A patient exhibits visual field defect, ataxia, and dysarthria and complains of a mild headache. A family member reports that the symptoms began several hours prior. An examination reveals normal range of motion of the neck. What type of cerebrovascular event is most likely?

A) Hemorrhagic stroke

B) Hypertensive intracerebral hemorrhage

C) Ischemic stroke

D) Transient ischemic attack (TIA)

Question 60

In terms of timing of pain, spondylitis is worse in the morning and better as the body “warms up.”

A) True

B) False

Question 61

The spouse of a patient newly diagnosed with amyotrophic lateral sclerosis (ALS) asks about long-term care. What will the provider include when teaching the family about this disease?

A) Bowel and bladder function will eventually be lost

B) Positive-pressure ventilation can prolong life.

C) Preventing malnutrition is a key element in care.

D) The nerves affecting sensation will die initially.

Question 62

Which is true about hypoactive sexual desire in older men?

A) Hypoactive sexual desire in older men is related to sexual aversion.

B) Hypoactive sexual desire is a conscious choice to avoid sexual relations.

C) Men with hypoactive sexual desire may have normal excitement and orgasm.

D) The most common type of sexual dysfunction is hypoactive sexual desire.

Question 63

Cryptorchidism increases the risk of testicular cancer.

A) True

B) False

Question 64

An older male patient reports gross hematuria but denies flank pain and fever. What will the nurse practitioner do to manage this patient?

A) Monitor blood pressure closely

B) Obtain a urine culture

C) Perform a 24-hour urine collection

D) Refer for cystoscopy and imaging

Question 65

Tawyna is a 21 y/o sexually active female who returns to the clinic for follow-up on her pelvic inflammatory disease (PID). Since her visit last week she complains of right upper quadrant abdominal pain and tenderness on palpation. Her new diagnosis is:

A) Fitz-Hugh-Curtis Syndrome

B) Jarisch-Herxheimer Reaction

C) Reiter’s Syndrome

D) None of the above.

Question 66

Andrea is a 23 y/o female who is sexually active. She douches frequently and has multiple sex partners. She presents to the clinic with the following chief complaint: “I have this really strong fish-like smell after I have intercourse. I then have large amounts of milk like draining from my vagina.” On speculum exam the NP notes an off-white, gray colored coating to the vaginal walls. Based on these data the NP diagnoses the Andrea as having:

A) Chlamydia

B) Gonorhhea 

C) Bacterial Vaginosis

D) Candidal Vaginitis

Question 67

Moussa is a 75 y/o African American male who presents to the clinic with the following symptoms: perianal pain, low back pain, night time urination, and weak urinary stream. Labs taken one week ago show a PSA of 6.0 ng/ml. The most likely diagnosis is:

A) Prostate Cancer

B) Testicular Torsion

C) Prostatitis

D) Epididymitis

Question 68

A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract infection. After treatment for the urinary tract infection (UTI), what testing is indicated for this patient?

A) 24-hour urine collection to evaluate for glomerulonephritis

B) Bladder scan

C) Repeat urinalysis

D) Voiding cystourethrogram

Question 69

Jerry is a 30 y/o male who comes to the clinic with a chief complaint of pain during erections and a “crooked penis.” He notes that he has palpable nodules on the penile shaft. The most likely diagnosis is:

A) Peyronie’s Disease

B) Erectile Dysfunction

C) Phimosis

D) Cryptorchidism

Question 70

Isaiah is an 19 y/o male who comes to the clinic with a chief complaint of a palpable nodule on his right testicle. He notes that it hurts and that it is larger than his left testicle. The most likely diagnosis is:

A) Prostate Cancer

B) Testicular Torsion

C) Testicular Cancer

D) Varicose vein

Question 71

A young adult male reports a dull pain in the right scrotum and the nurse practitioner notes a bluish color showing through the skin on the affected side. Palpation reveals a bag of worms on the proximal spermatic cord. What is an important next step in managing this patient?

A) Anti-infective therapy with ceftriaxone or doxycycline

B) Consideration of underlying causes of this finding

C) Reassurance that this is benign and may resolve spontaneously

D) Referral to an emergency department for surgical consultation

Question 73

Routine prostate cancer screening is recommended by the USPSTF.

A) True

B) False

Question 74

Tara is a 18 y/o female who has just been started been started on birth control pills (BCPs). The NP is educating Tara on danger signs that could lead to a thromboembolic event. Which of the following are indications of such an event:

1. Chest pain
2. Shortness of breath
3. Increase in headaches
4. Visual changes
5. All the Above
6. A, B, & D only
7.  

Question 75

Daniel is a 24 y/o marathoner who tripped and fell during a race. He was transported to the clinic, where an x-ray of his femur was noted to have the following: fracture of the bone with separation in 3 places, and broken skin at the level of the first bone fragment.

Possible complications to Daniel’s healing limb would include:

1. Muscle Spasms
2. Nerve Damage
3. Osteoarthritis
4. All the Above
5. all of the above except D

 

Question 76

Elizabeth is a 34 y/o female who comes to the clinic with a chief complaint of bilateral pain, swelling and warmth in her hand, knees and feet. Some of her systemic complaints are: fatigue, malaise, anorexia, weight loss, and fever.

In light of Elizabeth’s current diagnosis the NP knows that in the later stages of her disease she may well develop:

A) Boutonniere Deformities

B) Swan Neck Deformities

C) Ulnar Deviation of the metacarpophalangeal joints

D) All the Above

Question 77

A patient reports persistent lower back pain and constipation. A digital rectal examination reveals a mass at the sacrum. What will the primary care provider do to manage this patient?

A) Order spinal radiographs in 3 months

B) Perform an MRI of the sacrum

C) Refer the patient to an oncologist

D) Schedule the patient for a biopsy

Question 78

Andrew is a 29 y/o marathoner who tripped and fell during a race. He was transported to the clinic, where an x-ray of his femur was noted to have the following: fracture of the bone with separation in 3 places, and broken skin at the level of the first bone fragment. The NP would diagnose his fracture as:

A) Closed, complete

B) Closed, incomplete

C) complete, open

D) Complete, closed

Question 79

Loss of Achilles tendon reflex most likely indicates a lesion at L5 –S1.

A) True

B) False

 Question 80

A patient who is a distance runner reports pain in one heel that is worse in the morning and seems to improve with exercise. The provider notes localized swelling and a bony prominence at the heel. What is the initial treatment for this condition?

A) Cessation of all sports activities and exercise

B) Crutches and partial weight bearing

C) Physical therapy for ultrasound therapy

D) Referral to an orthopedist for MRI and evaluation

Question 81

The test for knee stability is which of the following:

A) Finkelstein’s Test

B) McMurray’s Test

C) Drawer Test

D) Lachman’s Sign

Question 82

A patient has pain on the plantar aspect of the heel with weight bearing after rest. The pain is worsened with dorsiflexion of the foot. What is the initial treatment for this patient?

A) A series of steroid injections

B) Avoiding all high-impact activities

C) Night splints

D) Wearing flat shoes only

Question 83

A patient with gout and impaired renal function who uses urate-lowering therapy (ULT) is experiencing an acute gout flare involving one joint. What is the recommended treatment?

A) Administration of intraarticular corticosteroid

B) Discontinuing ULT while treating the flare

C) Oral colchicine for 5 days

D) Therapy with NSAIDs begun within 24 hours

Question 84

A patient experiencing shoulder pain is seen by an orthopedic specialist who notes erythema, warmth, and fluctuance of the shoulder joint. What is the next step in treatment for this patient?

A) Admit to the hospital for intravenous antibiotics.

B) Inject lidocaine into the joint and reassess in 5 to 10 minutes.

C) Order a plain radiograph of the shoulder to identify possible fracture.

D) Perform a shoulder ultrasound to further evaluate the cause.

Question 85

Maria is a 29y/o Hispanic female who comes to the clinic with the following symptoms: joint pain, fever, and loss of appetite and weight, fatigue, and hair loss. On physical exam the NP notes that she has a malar rash on her face, arthritis, and an abnormal ANA titer. He/she also notes on the eye exam that she has cotton wool spots on the retina. With this little information the NP would be most inclined to have which one of the following differentials as his/her top priority:

A) Sjogrens

B) SLE

C) Fibromyalgia

D) None of the above.

Question 86

Luke is a 45 y/o male who comes to the clinic with a chief complaint of “early morning” stiffness after getting out of bed. He also notes that the joints on his knuckle areas are swollen. He further notes that at the end of the day, the stiffness returns. The most likely diagnosis for Luke is:

A) Osteoarthritis

B) Rheumatoid Arthritis

C) Bursitis

D) None of the Above.

Question 87

Lucas comes to the clinic with a knee injury that occurred while he was playing football. The NP examines the knees, performs the appropriate orthopedic maneuvers and thinks that Lucas may have a torn meniscus. Her next step would be to order which test:

A) Plain X-ray

B) MRI

C) CT Scan

D) None of the Above

Question 88

Emma is a 73 y/o female who recently lost her husband and feels hopeless. Her children live and work in Europe and rarely make it back home. She feels that she has no social support and that many of her closest friends have passed away. She feels that there is no end to her suffering. The primary assessment of her condition should focus on which major condition?

A) Depression

B) Suicide

C) Dementia

D) Delirium

Question 89

Abby is a 35 y/o female who was recently diagnosed with breast cancer. As a single mother with 2 small children she recently was furloughed from her position at a big box store because of the covid-19 pandemic. The comes to the clinic with a chief complaint of chest pain, palpitations, shortness of breath and dizziness).

Pharmacologic management of Abby’s disorder would include all the following except:

A) Selective Serotonin Re-uptake Inhibitors (SSRIs)

B) Antabuse

C) Benzodiazepines

D) Beta Blockers

Question 90

Abigail is a 34 y/o female who was recently diagnosed with breast cancer. As a single mother with 2 small children she recently was furloughed from her position at a big box store because of the covid-19 pandemic. The comes to the clinic with a chief complaint of chest pain, palpitations, shortness of breath and dizziness). Based on her symptoms the NP determines that she has:

A) Acute Situational Anxiety Disorder

B) Generalized Anxiety Disorder

C) Panic Disorder

D) Depression

Question 91

Mitchell is an 20 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Mitchell lost his best friend in a roadside bomb in Afghanistan.

Mitchell’s insomnia could be treated with which of the following natural supplements:

A) Kava-Kava

B) Valerian Root

C) Chamomile Tea

D) All the above

Question 92

A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines that these symptoms occur in relation to many events and concerns. What other things will the NP question this patient about?

A) Ability to manage social situations

B) Body image and eating habits

C) Headaches and bowel habits

D) Occupational performance

Question 93

Mike is an 19 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Mike lost his best friend in a roadside bomb in Afghanistan. Mike’s insomnia can be classified as:

A) Primary Insomnia

B) Secondary Insomnia

C) Short term Insomnia

D) Chronic Insomnia

Question 94

Which of the follow are risk factors for abuse?

1. Increased stress
2. Social Isolation
3. Alcohol/drug dependence
4. All the Above
5. A & B only

Question 95

A patient is seen frequently over a 9-month period with somatic complaints that are not related to physical disease. The NP notes that the patient has had a 15% weight loss in the previous 2 months and the patient reports difficulty sleeping. The patient’s spouse tells the NP that the patient seems tired all the time and is irritable with other family members. What will the NP do initially?

A) Perform a suicide risk assessment

B) Prescribe a selective serotonin reuptake inhibitor

C) Refer the patient for psychotherapy

D) Suggest cognitive-behavioral therapy

Question 96

Mia is a 29 y/o female who comes to the clinic with her partner. During the history taking her partner does not allow Mia to answer any of the questions but instead answers all the questions for her.

While doing the physical exam on Mia ,the NP should do all the following except:

A) Have another provider present

B) Collect visual evidence of trauma

C) Interview Mia and her partner together

D) When appropriate, develop a plan of safety

Question 97

A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of college and quit his job within the last 5 months. The parent is concerned that the patient may have schizophrenia because a maternal uncle has the disease. What will the provider do next?

A) Ask about the patient’s speech and thinking patterns

B) Consider treatment with antipsychotic medications

C) Reassure that classic symptoms of schizophrenia are not present

D) Refer the patient for inpatient psychiatric treatment

Question 98

A patient is diagnosed with panic disorder and begins taking a selective serotonin reuptake inhibitor (SSRI) medication. Six weeks later, the patient reports little relief from symptoms. What will the NP do next to manage this patient?

A) Change the medication to buspirone

B) Discontinue the medication

C) Increase the medication dose

D) Refer to a mental health provider

Question 99

In the elderly, depression often exists with dementia.

A) True

B) False

Question 100

Daniel a 47 y/o male has a smoking addiction and has smoked 2 packs /day for the past 26 years.

Daniel is at risk for which diseases as a result of his smoking addiction?

1. Osteoarthritis
2. Grave’s Disease
3. Oral Cancer
4. COPD
5. B, C & D only

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