Family Nurse Practitioner Clinical Management
Exam Answer Key
Course Introduction
Family Nurse Practitioner Clinical Management focuses on the comprehensive management of healthcare for individuals and families across the lifespan. This course emphasizes the development of advanced clinical reasoning and decision-making skills necessary for assessment, diagnosis, treatment, and evaluation of common acute and chronic health problems in primary care settings. Students will integrate principles of evidence-based practice, health promotion, disease prevention, and culturally competent care in the management of diverse populations. Clinical experiences and case studies provide opportunities to apply theoretical knowledge to real-world patient scenarios, fostering collaboration with interdisciplinary healthcare teams to optimize patient outcomes.
Recommended Textbook
Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses 3rd Edition
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Chapter 1: Assessment and Clinical Decision-Making: Overview
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Sample Questions
Q1) Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations,settings,and/or patients?
A) Clinical practice guideline
B) Clinical decision rule
C) Clinical algorithm
D) Clinical recommendation
Answer: B
Q2) Essential parts of a health history include all of the following except:
A) Chief complaint
B) History of the present illness
C) Current vital signs
D) All of the above are essential history components
Answer: C
Q3) If a diagnostic study has high specificity,this indicates a:
A) Low percentage of healthy individuals will show a normal result
B) High percentage of healthy individuals will show a normal result
C) High percentage of individuals with a disorder will show a normal result
D) Low percentage of individuals with a disorder will show an abnormal result
Answer: B
Page 3
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Chapter 2: An Overview of Genetic Assessment
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Sample Questions
Q1) A woman affected with an X-linked recessive disorder:
A) Has one X chromosome affected by the mutation
B) Will transmit the disorder to all of her children
C) Will transmit the disorder to all of her sons
D) Will not transmit the mutation to any of her daughters
Answer: C
Q2) Approximately what percentage of cancers is due to a single-gene mutation?
A) 50% to 70%
B) 30% to 40%
C) 20% to 25%
D) 5% to 10%
Answer: D
Q3) The pedigree of a family with a mitochondrial DNA disorder is unique in that:
A) None of the female offspring will have the disease
B) All offspring from an affected female will have disease
C) None of the offspring of an affected female will have the disease
D) All the offspring from an affected male will have disease
Answer: B
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Chapter 3: Skin
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Sample Questions
Q1) Which of the following characteristics is not helpful in differentiating between psoriasis and atopic dermatitis?
A) Distribution
B) Family history
C) Lesion morphology
D) Chronicity
Answer: D
Q2) A patient presents with vesicles on a reddened base in a symmetrical pattern on the lower neck and upper back,stating that he had noticed discomfort prior to the onset of the "rash." Which of the following should be considered in your differential diagnosis?
A) Dermatitis herpetiformis
B) Herpes zoster
C) Dishydrosis
D) Contact dermatitis
Answer: A
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5
Chapter 4: Head,face,and Neck
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Sample Questions
Q1) A patient with systemic lupus erythematosus has been taking a prolonged course of steroids.She complains that her face appears swollen and has experienced a 10-pound weight gain.This is often referred to as:
A) Angioedema
B) Parotitis
C) Cushingoid effect
D) Myxedema
Q2) A goiter is most commonly associated with:
A) Hypothyroidism
B) Hyperthyroidism
C) Euthyroid function
D) All of the above
Q3) The following is a sexually transmitted infection that can cause pharyngitis and cervical lymphadenopathy with oral sex:
A) Hemolytic streptococcus
B) Chlamydia trachomatis
C) Epstein-Barr virus
D) Cytomegalovirus
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6
Chapter 5: The Eye
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Q1) The most common cause of eye redness is:
A) Conjunctivitis
B) Acute glaucoma
C) Head trauma
D) Corneal abrasion
Q2) The most common type of eye disorder is:
A) Refractive errors
B) Macular conditions
C) Neurological conditions
D) Astigmatisms
Q3) Your patient describes blurry vision as well as halos and glares in response to bright lights or when driving in the dark.There is no pain.These are symptoms of:
A) Glaucoma
B) Macular degeneration
C) Cataracts
D) Diabetic retinopathy
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Chapter 6: Ear, nose, mouth, and Throat
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Q1) To examine if there is an intact gag reflex,ask the patient to say "ah" as you observe the:
A) Movement of the uvula to the left
B) Movement of uvula to the right
C) Tongue extension in the midline
D) Upward movement of the uvula in the midline
Q2) Nasal discharge of green-yellow mucus,pharyngitis,and otitis media commonly indicate:
A) Allergic rhinitis
B) Viral infection
C) Bacterial infection
D) Nasal polyps
Q3) Your patient is a 78-year-old female with a smoking history of 120-pack years.She complains of hoarseness that has developed over the last few months.It is important to exclude the possibility of:
A) Thrush
B) Laryngeal cancer
C) Carotidynia
D) Thyroiditis
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Page 8
Chapter 7: Cardiac and Peripheral Vascular Systems
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Sample Questions
Q1) Pain associated with a dissecting thoracic aortic aneurysm is commonly described as:
A) Retrosternal crushing and squeezing
B) Chest stabbing and sharp
C) Ripping and tearing in the chest or thoracic back
D) Worse with inspiration
Q2) Which is the most specific and sensitive test for validating a myocardial infarction?
A) 12-lead EKG
B) Troponin
C) CK-MB
D) CT scan
Q3) Your patient has had hypertension for 10 years,a myocardial infarction 5 years ago,and now complains of dyspnea on exertion,cough,and 3-pillow orthopnea.Which of the following conditions is likely?
A) Right ventricular failure
B) Pulmonary embolism
C) Cor pulmonale
D) Left ventricular failure
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Chapter 8: Respiratory System
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Sample Questions
Q1) Upon assessment of respiratory excursion,the clinician notes asymmetric expansion of the chest.One side expands greater than the other.This could be due to:
A) Pneumothorax
B) Pleural effusion
C) Pneumonia
D) Pulmonary embolism
Q2) Which of the following is considered a "red flag" when diagnosing a patient with pneumonia?
A) Fever of 102
B) Infiltrates on chest x-ray
C) Pleural effusion on chest x-ray
D) Elevated white blood cell count
Q3) Which of the following details are NOT considered while staging asthma?
A) Nighttime awakenings
B) Long-acting beta agonist usage
C) Frequency of symptoms
D) Spirometry findings
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Chapter 9: Breasts
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Sample Questions
Q1) When examining the breasts of a 45-year-old female patient,you note nodularity throughout both breasts.There is no dominant mass,tenderness,nipple change,or skin change.Which of the following condition is most likely?
A) Multiple fibroadenomas
B) Fibrocystic breasts
C) Mastalgia
D) Mastitis
Q2) A 23-year-old female presents with episodic bilateral breast tenderness.Upon palpation,there are multiple areas of nodularity with no dominant breast mass and no tenderness,nipple,or skin changes.It is best to recommend:
A) Ultrasound of the breasts
B) Mammogram of the breasts
C) Fine needle aspiration of one nodule within a breast
D) Diary of menstrual cycle and breast symptoms
Q3) Bloody breast discharge is associated with which of the following?
A) Bleeding disorder such as von Willebrand disease
B) Malignancy
C) Excessive non-steroidal anti-inflammatories
D) A and C
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Page 11
Chapter 10: Abdomen
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Sample Questions
Q1) The major sign of ectopic pregnancy is:
A) Sudden onset of severe epigastric pain
B) Amenorrhea with unilateral lower quadrant pain
C) Lower back and rectal pain
D) Palpable abdominal mass
Q2) Your patient demonstrates positive shifting dullness on percussion of the abdomen.This is indicative of:
A) Cholecystitis
B) Appendicitis
C) Ascites
D) Hepatitis
Q3) Your patient complains of lower abdominal pain,anorexia,extreme fatigue,unintentional weight loss of 10 pounds in last 3 weeks,and you find a positive hemoccult on digital rectal examination.Laboratory tests show iron deficiency anemia.The clinician needs to consider:
A) Diverticulitis
B) Appendicitis
C) Colon cancer
D) Peptic ulcer disease
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Chapter 11: Genitourinary System
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Sample Questions
Q1) A 27-year-old male comes in to the clinic for symptoms of dysuria,urinary frequency,as well as urgency and perineal pain.Transrectal palpation of the prostate reveals a very tender,boggy,swollen prostate.The clinician should recognize these as signs of:
A) Prostatitis
B) Prostate cancer
C) Urethritis
D) Benign prostatic hyperplasia
Q2) A 65-year-old male patient complains of frequency,urgency,hesitancy,and weak urine stream.Physical examination is unremarkable except DRE reveals an enlarged,firm,non-tender prostate gland.Urine culture reveals 100 bacteria CFU/mL.The clinician should suspect:
A) Lower urinary tract infection due to benign prostatic hyperplasia
B) Bacteriuria due to prostatitis
C) Obstructive uropathy due to prostate cancer
D) Upper urinary tract infection due to benign prostatic hyperplasia
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Chapter 12: Male Reproductive System
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Sample Questions
Q1) Your male patient is 456 pounds and complains of erectile dysfunction.On physical examination,you note gynecomastia,decreased pubic,facial,and axillary hair,as well as atrophic testes.This is due to:
A) Vascular disease that affects the testes
B) Conversion of testosterone in fatty tissue to estradiol
C) Androgen resistance of fatty tissue
D) All of the above
Q2) A male and female patient complain of problems with conception.The female patient is in generally good health.The male patient is a body builder who admits to anabolic steroid use.It is important for the clinician to recognize that in male steroid users,there is often:
A) Atrophic testes
B) Excessive natural testosterone
C) Inadequate natural testosterone
D) A & C
Q3) Which of the following most commonly causes balanitis?
A) Tinea
B) Syphilis
C) Candida
D) Gonorrhoea
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Chapter 13: Female Reproductive System
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Sample Questions
Q1) Which of the following infections can cause an eye infection in the newborn during vaginal delivery?
A) Candida vaginitis
B) Chlamydia trachomatis
C) Trichomonas vaginalis
D) Gardnerella vaginalis
Q2) Your 24-year-old female patient comes to the clinic for a routine pelvic exam and Pap smear.It is recommended that a female of this age obtain a Pap smear:
A) Every year
B) Every 3 years
C) Every 5 years
D) None of the above
Q3) A 38-year-old female complains of having trouble with conception.It is important to ask the patient to:
A) Schedule a date for pelvic exam and Pap smear
B) Chart at least three menstrual cycles
C) Take basal body temperature for 3 cycles
D) B and C
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Chapter 14: Musculoskeletal System
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Sample Questions
Q1) Muscle strength is assessed by:
A) Having the patient move their muscle against the clinician's resistance
B) Examining how the patient performs active range of motion
C) Passively stretching the patient's muscle
D) Performing passive range of motion on the patient's muscle
Q2) Your patient is a 55-year-old male who presents with sudden,severely tender,swollen,erythematous elbow.The patient reports that he experienced similar symptoms in the past.You note the right elbow has a swollen,tender,soft 3 cm round nodule.The clinician should recognize these are signs and symptoms of:
A) Gouty arthritis
B) Rheumatoid arthritis
C) Epicondylitis
D) Reiter's syndrome
Q3) To assess muscle tone,the clinician should:
A) Palpate the patient's muscle as the muscle is passively stretched
B) Examine how the patient performs active range of motion
C) Palpate the muscles comparing side to side
D) A and C
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Chapter 15: Neurological System
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Sample Questions
Q1) A 65-year-old woman is accompanied by her daughter for a physical examination.She has mild heart failure and takes digitalis and an ACE inhibitor.As you examine the patient,you note flat affect,hand tremor,and slowed movements.The tremor is worsened at rest.There are no neurologic deficits.Hand grip,sensation of face and extremities,and lower extremity muscle strength are within normal limits and bilaterally equal.DTRs are equal bilaterally.CN II to XII are intact.The mental status exam is normal.These are key signs of:
A) Chiari malformation
B) Normal pressure hydrocephalus
C) Parkinson's disease
D) Drug toxicity
Q2) A 41-year-old male patient presents to the emergency department complaining of severe headache pain.He describes it as a piercing,right sided head pain that occurred earlier in day for about 1 hour and now is recurring.You note lacrimation and rhinorrhea on the right side of the face.Which of the following types of headache is the patient describing?
A) Sinusitis
B) Cluster headache
C) Migraine
D) Subdural hematoma
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Chapter 16: Nonspecific Complaints
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Q1) A 32-year-old morbidly obese male complains of excessive fatigue,snoring,and awakening in the middle of the night,which prevents restorative sleep.He is sluggish during the day due to the lack of sleep and feels like he is going "fall asleep at the wheel" when driving to work.Occupation: dishwasher.Medical history includes hypertension and type 2 diabetes.Current medications include ACE inhibitor and metformin.Denies use of alcohol,tobacco,or drugs.On physical examination,the patient is afebrile,pulse 88,resps 20/min,BP 178/95.BMI is 45.These are signs and symptoms of:
A) Obstructive sleep apnea
B) Primary insomnia
C) Heart failure
D) All of the above
Q2) Which of the following disorders is associated with unintentional weight loss?
A) Clinical depression
B) Hyperthyroidism
C) Diabetes
D) All of the above
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18
Chapter 17: Psychiatric Mental Health
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Sample Questions
Q1) A manic episode is a distinct period of a persistently elevated,expansive,or irritable mood lasting at least:
A) 1 week
B) 2 weeks
C) 3 months
D) 6 months
Q2) Thought disorders are evaluated in terms of:
A) The patient's ability to form an accurate assessment of reality
B) How the patient presents his or her ideas
C) The patient's perception of stimuli in the environment
D) All of the above
Q3) Which of the following medications may cause depression in some individuals?
A) Amantadine
B) "Statin" anti-lipidemia drugs
C) Levodopa
D) A and C
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Chapter 18: Pediatric Patients
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Sample Questions
Q1) In infants,the following is a serious examination finding:
A) Lack of red reflex
B) Eyelid telangiectasia
C) Delayed pupillary reaction
D) A and C
Q2) Criteria for diagnosing ADHD in a child include attention problems that:
A) Have been present before the age of 12
B) Have been present for at least 6 months
C) Are present in at least two settings
D) All of the above
Q3) Which of the following is true regarding growth and development of a child?
A) Average head circumference of an infant under 6 months is 13 to 14 inches
B) The head circumference generally increases by a half inch per month during the first 6 months
C) A child's weight typically doubles by 4 to 6 months
D) All of the above
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Chapter 19: Pregnant Patients
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Sample Questions
Q1) Your pregnant patient is at 8 weeks' gestation and complains of pain that radiates from the wrist into the fingers in the right hand.She is a computer programmer and uses a keyboard daily for 6 hours or more.The clinician should:
A) Ask the person to place dorsal surfaces of hands together to check for Phalen's sign
B) Teach the patient that carpal tunnel syndrome is common during pregnancy
C) Tap the patient's right wrist to try to elicit tingling in the fingers for Tinel's sign
D) All of the above
Q2) Your pregnant patient at 8 months gestation complains of bilateral ankle swelling and no other symptoms.Which of the following findings require further investigation?
A) Ankle swelling that is noticed at the end of the day after standing for prolonged time
B) Weight gain of approximately 1 lb per week
C) A systolic rise of 30 mm Hg or diastolic rise of 15 mm Hg over the patient's baseline BP
D) Uterine fundus above the umbilicus
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21
Chapter 20: Older Patients
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Q1) A preliminary,concise test to screen patients for dementia in primary care is the:
A) Mini-mental status exam (MMSE)
B) Mini-Cog Clock Drawing test
C) Geriatric Depression Scale
D) Physical Self-Maintenance Scale
Q2) During examination of the eyes,dilation of the pupil is needed to check for:
A) Distance vision
B) Macular degeneration
C) Cataracts
D) Peripheral vision
Q3) Useful laboratory measures that indicate protein-energy malnutrition in hospitalized elders include a serum albumin level below.
A) 3.4 g/dl
B) 4.2 g/dl
C) 5.2 g/dl
D) 6.4 g/dl
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