Primary Care Nursing
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Course Introduction
Primary Care Nursing focuses on equipping students with the knowledge and skills necessary to deliver comprehensive, patient-centered care within community and primary care settings. The course emphasizes health promotion, disease prevention, management of common acute and chronic illnesses, and the importance of collaboration within interdisciplinary teams. Students learn to conduct effective health assessments, develop evidence-based care plans, educate diverse populations, and utilize resources to address social determinants of health. Through theoretical instruction and practical experience, learners gain competencies crucial for enhancing access to quality care and improving health outcomes at the primary level.
Recommended Textbook
Primary Care Art and Science of Advanced Practice Nursing 4th Edition by Dunphy
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549 Verified Questions
549 Flashcards
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Chapter 3: Health Promotion
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Sample Questions
Q1) Which of the following is an example of secondary prevention in a 50-year-old woman?
A)Yearly mammogram
B)Low animal fat diet
C)Use of seat belt
D)Daily application of sunscreen
Answer: A
Q2) Prevalence is the number of new cases of a particular disease.
A)True
B)False
Answer: False
Q3) Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
A)Fluid restriction
B)Hemodialysis 4 days a week
C)High-protein diet
D)Maintenance of blood pressure at 120/80
Answer: B
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Chapter 5: Evidence-Based Care
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Sample Questions
Q1) Which of the following would be considered the research design for Level VII evidence?
A)Well-designed controlled trials without randomization
B)Opinion of authorities and expert committees
C)Well-designed case control or cohort studies
D)Single descriptive or qualitative study .
Q2) Which of the following are parts of evidence-based practice?
A)Clinician
B)Patient
C)Evidence
D)All of the above
Q3) Applying evidence at the point of care requires:
A)Readily available evidence-based resources
B)Ability to review research literature
C)Single articles in journals
D)Current textbooks
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Chapter 6: Neurological Problems
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Sample Questions
Q1) What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
A)A stabbing pain on one small area of the body
B)A vesicular skin lesion on one side of the body
C)A pain that is worse upon awakening
D)A lesion on the exterior ear canal
Q2) Which statement is true regarding driving and patients with a seizure disorder?
A)Once diagnosed with a seizure disorder, patients must never drive again.
B)After being seizure free for 6 months, patients may drive.
C)Each state has different laws governing driving for individuals with a seizure disorder.
D)These persons may drive but never alone.
Q3) A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?
A)Spinothalamic dysfunction
B)Ratcheting
C)Cogwheeling
D)Hand tremors
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5
Chapter 7: Skin Problems
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Sample Questions
Q1) Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head.How do you respond when he asks you the cause?
A)"You must be under a lot of stress lately."
B)"It is hereditary.Did your father experience this also?"
C)"The cause is unknown, but we suspect it is due to an immunologic mechanism."
D)"We'll have to do some tests."
Q2) Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?
A)Keratosis pilaris
B)Dennie's sign
C)Keratoconus
D)Pityriasis alba
Q3) Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?
A)Do not use lidocaine as it may potentiate bleeding.
B)Pinch the skin taut together.
C)Use gel foam to control bleeding.
D)This should be performed by a dermatologist only.
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Chapter 8: Eyes, Ears, Nose, and Throat
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Sample Questions
Q1) You are in the park playing with your children when you see that your friend is screaming for help.Her toddler has fallen and there is a stick lodged in his eye.The child is kicking and screaming and grabbing for the stick.You:
A)instruct his mother to hold him securely and not allow him to touch the stick, then carefully remove the stick from the eye.
B)stabilize the foreign object and accompany the mother and child to the local ER.
C)find a water fountain, hold the child to the water, and flush the eye.
D)call 911.
Q2) Which immunoglobulin mediates the type 1 hypersensitivity reaction involved in allergic rhinitis?
A)IgA
B)IgE
C)IgG
D)IgM
Q3) Severe pain associated with acute otitis media signifies perforation of the tympanic membrane.
A)True
B)False
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Chapter 9: Respiratory Problems
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Sample Questions
Q1) Julie has a postnasal drip along with her cough.You assess her for:
A)Asthma
B)Sinusitis
C)Allergic or vasomotor rhinitis
D)Influenza
Q2) Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD?
A)3 to 5 hours
B)6 to 10 hours
C)11 to 14 hours
D)15 to 18 hours
Q3) Which of the following is a possible consequence of sleep apnea?
A)Asthma
B)Increased white blood cells
C)Insulin resistance
D)Hyperactivity
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Chapter 10: Cardiovascular Problems
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Sample Questions
Q1) Lifestyle modifications to manage hypertension (HTN) include:
A)Maintaining a body mass index of 17
B)Restricting dietary sodium to 2 grams per day
C)Engaging in exercise or physical activity for 90 minutes a day
D)Limiting beer intake to 24 ounces per day
Q2) Statins are approved for which age group?
A)Children over the age of 2
B)Children over the age of 6
C)Children over the age of 10
D)Only adolescents and adults
Q3) Mary has hypertension and previously had a stroke.Which hypertensive drug would you order for her?
A)Angiotensin converting enzyme inhibitor
B)Calcium channel blocker
C)Angiotensin II receptor blocker
D)Beta blocker
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Chapter 11: Abdominal Problems
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Sample Questions
Q1) A patient is diagnosed with GERD, and his endoscopic report reveals the presence of Barrett's epithelium.Which of the following should the PCP include in the explanation of the pathology report?
A)This is a premalignant tissue.
B)This tissue is resistant to gastric acid.
C)This tissue supports healing of the esophagus.
D)All of the above
Q2) A 35-year-old female patient is seen in the clinic complaining of abdominal pain.Which of the following should be included in the history and physical examination?
A)Digital rectal exam
B)Pelvic exam
C)Sexual history
D)All of the above
Q3) Which of the following is associated with celiac disease (celiac sprue)?
A)Malabsorption
B)Constipation
C)Rectal bleeding
D)Esophageal ulceration
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10
Chapter 12: Renal Problems
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Sample Questions
Q1) Which of the following examination findings should be expected in a patient with chronic renal failure (CRF)?
A)Weak, thready pulse
B)Auscultatory crackles
C)Hypotension
D)Pleural friction rub
Q2) The result of the patient's 24-hour urine for protein was 4.2 g/day.The clinician should take which of the following actions?
A)Repeat the test.
B)Refer to a nephrologist.
C)Measure the serum protein.
D)Obtain a blood urea nitrogen (BUN) and creatinine.
Q3) Which of the following clinical manifestations are consistent with a patient in ARF?
A)Pruritis
B)Glycosuria
C)Irritability
D)Hypotension
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Chapter 13: Mens Health Problems
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Sample Questions
Q1) Which test is used to confirm a diagnosis of epididymitis?
A)Urinalysis
B)Gram stain of urethral discharge
C)Complete blood cell count with differential
D)Ultrasound of the scrotum
Q2) What is the treatment of choice for a patient diagnosed with testicular cancer?
A)Radical orchidectomy
B)Lumpectomy
C)Radiation implants
D)All of the above
Q3) A 60-year-old man presents with an enlarged scrotum.The clinician uses a penlight to transilluminate the scrotum.In a patient with a hydrocele, what would the clinician expect to find?
A)The scrotum will be dark.
B)The scrotum will appear light pink or yellow.
C)The scrotum will appear milky white.
D)The internal structures will be clearly visible.
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Chapter 14: Womens Health Problems
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Sample Questions
Q1) A 15-year-old girl is seen in the clinic because she has not yet had her first period.Which of the following questions would help the clinician determine the cause?
A)"Are you sexually active?"
B)"How long have you been underweight?"
C)"Did your mother take diethylstilbestrol during her pregnancy?"
D)"Have you noticed any changes in your moods lately?"
Q2) A 40-year-old woman is seen for her yearly examination.She is single and not in a monogamous relationship.Her social history includes smoking cigarettes "occasionally" and drinking about two beers a day.Her body mass index (BMI) is 25.She is requesting birth control.Which of the following methods would be best for this patient?
A)Intrauterine device
B)Oral contraceptive
C)Condom
D)Vaginal contraceptive sponge
Q3) Most breast cancer cases are in women with a family history of breast cancer.
A)True
B)False
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Chapter 15: Musculoskeletal Problems
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Sample Questions
Q1) The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.
A)True
B)False
Q2) Mrs.Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome.She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome.Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome?
A)Carpal tunnel syndrome commonly occurs in families.Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.
B)Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.
C)An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.
D)Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.
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Chapter 16: Endocrinemetabolic Problems
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Sample Questions
Q1) A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good.Which of the following responses would be most appropriate?
A)"Control of glucose will help postpone or delay complications."
B)"Regularly checking blood sugar will help establish a routine."
C)"Monitoring glucose will promote a sense of control."
D)All of the above
Q2) A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus.Which of the following should be included in the differential diagnosis?
A)Anxiety disorder
B)Pheochromocytoma
C)Psychosis
D)All of the above
Q3) Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?
A)Insulin
B)Metformin
C)Glucotrol
D)Precose
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Chapter 17: Hematologic and Immune Problems
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Sample Questions
Q1) Infectious mononucleosis results from an acute infection with which of the following?
A)Epstein-Barr virus
B)Acute HIV infection
C)Guillain-Barre
D)Hepatitis
Q2) As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?
A)Two
B)Three
C)Four
D)Five
Q3) In the United States, what is the second most common connective tissue disease and the most destructive to the joints?
A)Osteoarthritis
B)Systemic lupus erythematosus (SLE)
C)Rheumatoid arthritis
D)Sj gren's syndrome
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Chapter 18: Psychosocial Problems
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Sample Questions
Q1) After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?
A)2 weeks
B)3 weeks
C)4 weeks
D)5 weeks
Q2) Which of the following symptoms is not part of the diagnostic criteria for post-traumatic stress disorder (PTSD)?
A)Hypersomnolence
B)Blunted feelings
C)Loss of interest in significant activities
D)Intrusive recurrent recollections of the event
Q3) What is recorded as clinical category two of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)?
A)Clinical disorder or focus of clinical attention
B)Personality or environmental problems
C)Environmental and psychosocial stressors
D)Global assessment of functioning
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Chapter 19: Emergency Problems
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Sample Questions
Q1) Pink, cherry red tissues and skin may result from which type of poisoning?
A)Arsenic
B)Lead
C)Carbon monoxide
D)Strychnine
Q2) If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?
A)Permanent tissue damage may occur, resulting in necrosis to that body part.
B)The area will be super sensitive.
C)The area is prone to a repeat frostbite.
D)The area is as susceptible as any other area.
Q3) What percentage of burns is involved using the rule of nines if both front legs are burned?
A)9%
B)18%
C)24%
D)36%
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Chapter 20: Palliative Care
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Sample Questions
Q1) According to the World Health Organization's analgesic ladder, which drug combination would be most appropriate in an opiate-na ve patient who presents with moderate pain?
A)Ibuprofen/imipramine
B)Naproxen/morphine
C)Aspirin/fentanyl
D)Indomethacin/hydrocodone
Q2) Oxygen has shown no benefit in alleviating dyspnea in patients without hypoxemia.
A)True
B)False
Q3) Which of the following statements is true regarding pain?
A)If a patient complains of pain but has no physical signs, he or she is most likely exhibiting drug-seeking behaviors.
B)Acute pain is more intense and severe than chronic pain.
C)Pain is a subjective experience related to actual or potential tissue damage.
D)All of the above
Q4) Some anticonvulsant drugs can be used as an adjuvant treatment for mild pain.
A)True
B)False
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Chapter 21: Ethical and Legal Issues of a Caring-Based Practice
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Sample Questions
Q1) In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the "C" of LACE represents?
A)Commitment
B)Consensus
C)Certification
D)Collaboration
Q2) When may confidentiality be overridden?
A)When personal information is available on the computer
B)When a clinician needs to share information with a billing company
C)When an insurance company wants to know the results of a breast cancer gene test
D)When a patient has a communicable disease
Q3) The main mechanism for avoiding a lawsuit involves:
A)Good liability insurance
B)A collaborating physician
C)Good documentation
D)Open communication skills
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Chapter 22: Business of Advanced Practice
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Sample Questions
Q1) Current procedural terminology (CPT) coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners.Clinicians are paid based on calculated resource costs that, in turn, are based on practice components.Which of the following is a part of the components used to calculate the per CPT code payment rate?
A)Clinician education loans
B)Clinician practice liability and malpractice expense
C)Clinician reported cost reduction efforts
D)Clinician volume of patients treated
Q2) Clinicians who learn how to code and document Evaluation and Management and clinician services will be more successful in gaining timely payment for care delivery.Which of the following CMS practices is designed to financially penalize clinicians who do not bill according to CMS guidelines?
A)Audits and probes
B)Add-on codes
C)Modifier codes
D)HAC guidelines
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Chapter 23: The 15-Minute Hour
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Sample Questions
Q1) The BATHE technique was developed more than 20 years ago and has been used extensively in primary care and family practice.The new 'Positive BATHE' stresses:
A)A belief that all things are possible through positive affirmations
B)A belief that one should only refer to practitioners who embrace the viewpoint of positive psychology
C)Personal accomplishment, thankfulness, autonomy, and general positive effect
D)The patient's problems and concerns
Q2) BATHEing the patient refers to:
A)A technique used in primary care to get the patient to accept the need for psychological or psychiatric referral
B)A technique used to facilitate cultural understanding
C)A technique used to perform psychotherapy
D)A technique that is a quick screen for psychiatric issues and interventions for psychological problems
Q3) The primary purpose of the "Positive BATHE" is intended to help patients by:
A)Focusing on autonomy and accomplishment
B)Creating a stronger therapeutic alliance
C)Helping the patient change negative behaviors
D)Engaging the patient during the psychosocial assessment .
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Page 22
Chapter 24: Putting Caring Into Practice: Caring for Self
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Sample Questions
Q1) Self-care and personal development are built into the standards of practice of:
A)The American Holistic Nurses Association
B)The American Nurses Association
C)The American Association of Nurse Practitioners
D)The American Academy of Nursing
Q2) The following statement is true:
A)APRNs are often sensitive to patients' deficiencies but not their own.
B)APRNs always respond appropriately to patients, families, and team members.
C)APRNs are well-equipped from their APRN educational programs to care for self.
D)Relicensure in some states mandates continuing education units in self-care.
Q3) There are many pressures inherent in primary care practice today for APRNs.These pressures include all of the following:
A)Electronic medical record, the Affordable Care Act, and the implementation of socialized medicine
B)Patient care outcomes being tied to reimbursement, role diffusion with physicians and physician assistants
C)Uncertainty, the team approach to care, and the need for patient-centered care
D)Availability of medical information on the internet, educational programs for patients, and Medicare drug benefits
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Page 23