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NR667 FNP Final Diagnostic Exam

Question 1

The patient is being evaluated for Hashimoto’s thyroiditis. Which test would be useful to specifically evaluate for this as the underlying pathology of the patient’s hypothyroidism?

1. Ultrasound the thyroid for hot nodules
2. Antinuclear antibody testing
3. Check anti-thyroperoxidase levels ✅
4. Ultrasound the thyroid for cold nodules

Question 2

The determination of topical corticosteroid potency is largely based on the unique drug as well as which of the following variables:

1. Duration of use (once, continuous, etc).
2. None of these are correct.
3. Vehicle of delivery (cream, lotion, elixir, etc). ✅
4. Site of use (back, face, arms, etc).

Question 3

Your patient is experiencing swelling of the face and is having difficulty breathing after a bee sting. Which of the following represents the most common immunoglobulin to blame for this response?

1. IgD
2. IgM
3. IgG
4. IgE ✅

Question 4

Treatment of type 1 hypersensitivity reaction may include all but which of the following?

1. Epinephrine (Epi-Pen).
2. All of these may be used to treat type 1 hypersensitivity reactions. ✅
3. Diphenhydramine (Benadryl).
4. Prednisone (Deltasone).

Question 5

You perform a sensory assessment on the face and notice abnormal lateral gaze in the left eye. Which one of the following cranial nerves would you expect to cause this abnormality?

1. Abducens nerve ✅
2. Trochlear nerve
3. Trigeminal nerve
4. Facial nerve

Question 6

Female patients who present with migraine with aura must avoid which of the following common medications?

1. Progesterone
2. Carbonic Anhydrase Inhibitors
3. Estradiol ✅
4. Bisphosphonates

Question 7

Which of the following diagnoses does NOT require Caesarean section?

1. Abruptio Placentae
2. Placenta Previa
3. Subchorionic hemorrhage ✅
4. Late decelerations on fetal monitoring during active labor

Question 8

Your 21 year old sexually active female patient states during a routine health exam that they have some “weird bumps” on their vulva. She is concerned she has a sexually transmitted infection. You notify her that condyloma are caused by exposure to which of the following?

1. Herpes zoster
2. Human papillomavirus type 6 and 11 ✅
3. Parvovirus B19
4. Chlamydia

Question 9

Melissa, your 56 year old caucasian female patient presents with a health history of hypertension, migraines, hyperlipidemia, seasonal depression, and obesity (BMI 32) for a visit to establish care. She was without any medical care for a long time and being newly established to your clinic is prescribed the following: aspirin (Bayer) 81mg PO daily, atorvastatin (Lipitor) 40mg PO daily, ezetimibe (Zetia) 10mg PO daily, lisinopril (Zestril) 20mg PO daily, amlodipine (Norvasc) 10mg PO daily and bupropion (Wellbutrin) 300mg PO daily as well as diet and exercise. After the visit, she calls your office nurse and states she has been experiencing a dry hacking cough since starting these meds after your visit. Which of the pharmacologic agents she is prescribed is most likely the common cause of these side effects?

1. Amlodipine (Norvasc)
2. Ezetimibe (Zetia)
3. bupropion (Wellbutrin)
4. Lisinopril (Zestril) ✅

Question 10

As a prudent nurse practitioner, you know that a 28 year old male patient with human immunodeficiency virus (HIV) would be considered well managed when they have which of the following in addition to having undetectable or very low viral copies.

1. CD4 count of >200 ✅
2. CD4 count of <200
3. Natural Killer Cell count of 184
4. CD4 count undetectable.

Question 11

Your patient appears to have iron deficiency anemia. Which of the following would you expect to be HIGH on initial labwork if this is a correct diagnosis?

1. Vitamin B12
2. anti-Thyroperoxidase (anti-TPO)
3. Total iron binding capacity (TIBC) ✅
4. Ferritin

Question 12

Gladys, a 51 year old female patient presents with pallor, weakness, and a microcytic anemia. Assuming iron deficiency anemia, you discuss treatment options while waiting for her confirmatory lab work to return. In your education with Gladys, you note that treatment of an iron deficiency anemia would be augmented by the use of which substance in addition to ferrous sulfate?

1. Vitamin A.
2. Vitamin B.
3. Vitamin D.
4. Vitamin C. ✅

Question 13

Sara, a 28 year old female patient presented to your clinic with wheezing and despite being treated with nebulized albuterol, she is not having any relief. You believe she is experiencing status asthmaticus. As a prudent nurse practitioner, you recall she may benefit from IM injection if which of the following agents?

1. Atropine (AtroPen).
2. Glucagon (GlucaGen).
3. Albuterol (Xopenex).
4. Terbutaline (Bricanyl). ✅

Question 14

Your patient presents with a unilateral visual defect with both eyes having loss of visual fields on the right side. This is known as homonymous hemianopsia and suggests which of the following causes?

1. Acute angle closure glaucoma
2. Impending stroke from carotid plaque
3. Cerebral infarction affecting one half of visual cortices ✅
4. Temporal arteritis

Question 15

Your patient is placed on a loop diuretic for CHF management. He asks you about the differences between the hydrochlorothiazide (HCTZ) he was on for hypertension and this drug as far as his electrolytes. Which of the following is the most accurate statement you can provide?

1. Thiazides cause more potent diuresis and therefore require more active electrolyte replacement with daily co-administration
2. Thiazides increase potassium since they are potassium sparing, unlike loop diuretics
3. Both will decrease serum K, Mg, Phos, and Calcium
4. Both decrease serum K, Mg, and Phos, but Thiazides will increase serum calcium and loop diuretics will decrease serum calcium ✅

Question 16

Your patient has presented with progressive asthma which has prompted you to increase therapy from short acting beta agonist only to other agents. Which drug must never be used as monotherapy for asthma management?

1. Mast cell stabilizers.
2. Inhaled corticosteroids.
3. Long acting beta agonists. ✅
4. Leukotriene inhibitors.

Question 17

Your patient has a diagnosis of Cushing’s disease. Which of the following would you expect to find during examination?

1. Low blood pressure
2. Low blood sugar
3. Abdominal striae. ✅
4. Low body temperature.

Question 18

Your patient with a diagnosis of severe cirrhosis is being seen in your clinic for routine liver serology and follow-up examination. Which of the following is the best tool to evaluate them for liver function while they await consideration for liver transplant?

1. A Model for End Stage Liver Disease (Meld) Score ✅
2. Alanine Transaminase (ALT)
3. Aspartate Transaminase (AST)
4. Gamma-Glutamyl Transferase (GGT)

Question 19

Your 15 year old female patient has presented with dysfunctional uterine bleeding (DUB). Based on the most common cause of DUB, which of the following lab tests should be ordered by the nurse practitioner first?

1. CBC.
2. Serum urine ketones
3. Serum beta human chorionic gonadotropin (HCG) ✅
4. Vitamin K.

Question 20

You are evaluating a 39 year old female patient in your clinic with symptoms of right upper quadrant pain which worsens with deep breathing. The patient exhibits a positive Murphy sign. These findings are most consistent with which one of the following?

1. Cholecystitis. ✅
2. Crohn’s flare
3. Appendicitis.
4. Pancreatitis.

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Related: (Completed) NR668 FNP Final Diagnostic Exam