PRIMARY CARE ART AND SCIENCE OF
ADVANCED PRACTICE NURSING PRACTICE
TEST 2026 QUESTIONS WITH ANSWERS
GRADED A+
◉ Neurologic Exam: A bit of Orientation. Answer:
https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/neu
rosurgery/images/5-minute-neuro-exam-handout.pdf
4 Minute Neuro Exam
◉ Components of the Neurologic Exam. Answer: Mental Status
Cranial Nerves
Motor Exam
Sensory Exam
Coordination
Reflexes
Gait
◉ Cranial Nerves. Answer: On Old Olympus Towering Tops A Finn
and German Viewed Some Hops
Some say marry money but my brother says big brains matter more
,◉ Confusion. Answer: Confusion is not a disease process or disease
state but rather a symptom. Confusion is an inability to think quickly
or coherently. A confused patient may be disoriented to time, place,
or person and usually demonstrates impairment of cognitive
functioning. It is usually demonstrated by inappropriate reactions to
environmental stimuli, may arise suddenly or gradually, and may be
either temporary or irreversible. Stressful events, lack of sleep or
food, or sensory deprivation may precipitate confusion. Age is not a
reliable predictor; however, older adults are most at risk because of
polypharmacy (multiple prescription drugs), the aging process,
preexisting dementia, and the presence of chronic disease.
◉ Confusion: Differential Diagnosis. Answer: Confusion is a key sign
of neurologic disorders. The physical examination will provide clues.
One major difficulty lies in differentiating symptoms of delirium
from dementia. The clinician must establish whether the patient has
delirium, a delirium superimposed on another condition such as
Alzheimer's disease (AD), or another neurocognitive disorder apart
from delirium, such as dementia. Once the disease has been
identified and treatment started, the symptom of confusion may
disappear.
Differential diagnoses for confusion involve almost all body systems
◉ Dementia. Answer: Dementia is a decline in mental functioning,
affecting memory, cognition, language, and personality. persistent or
more severe confusion, with or without psychomotor hyperactivity
,characterized by a significant time span between symptom
appearance and death, defines dementia.
Delirium is An acute transient disturbance in thought process
Clinically significant confusion states in older patients may lead the
provider to suspect dementias such as AD; multi-infarct dementia as
a result of CVA, or vascular dementia; depression, which can cause
dementia; or excessive consumption of alcohol or drugs, which can
also cause dementia.
◉ Dementia: Continued. Answer: The Diagnostic and Statistical
Manual of Mental Disorders (fifth edition; American Psychiatric
Association, 2013) 6th ed, now available. defines dementia as
significant cognitive impairment that represents a significant decline
from a previous level of functioning.
Cognitive impairment refers to a decline in at least one of the
following cognitive domains:
Language
executive function
Attention
perceptual-motor function
social cognition
Learning
Memory
, The disturbance must interfere with independence in everyday
activities and not be better accounted for by another neurocognitive
disorder.
◉ Dementia: Continued. Answer: Treatment for dementia is disease
specific. Treatment of AD consists of both pharmacologic and
nonpharmacologic measures. Pharmacologic therapy consists
primarily of Menantine (Namenda).
memantine and cholinesterase inhibitors (such as donepezil and
rivastigmine) are both used for moderate to severe AD
the combination of both memantine and donepezil may be more
effective than either alone
Nonpharmacologic measures include cognitive rehabilitation,
exercise, and occupational therapy
Antipsychotic drugs such as haloperidol (Haldol), quetiapine
(Seroquel), risperidone (Risperdal), olanzapine (Zyprexa), and
aripiprazole (Abilify) continue to be used to treat agitation and
aggression, but there is limited evidence of clinical benefit. Caution
must be taken as to the risks of increased cerebrovascular events.
Risperidone is the only recommended antipsychotic and should only
be used for 3 months.
Carbamazepine (Tegretol) is an anticonvulsant that may control
impulsivity and aggression
Patients with panic disorders may respond to lorazepam (Ativan) or
oxazepam (Serax).
ADVANCED PRACTICE NURSING PRACTICE
TEST 2026 QUESTIONS WITH ANSWERS
GRADED A+
◉ Neurologic Exam: A bit of Orientation. Answer:
https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/neu
rosurgery/images/5-minute-neuro-exam-handout.pdf
4 Minute Neuro Exam
◉ Components of the Neurologic Exam. Answer: Mental Status
Cranial Nerves
Motor Exam
Sensory Exam
Coordination
Reflexes
Gait
◉ Cranial Nerves. Answer: On Old Olympus Towering Tops A Finn
and German Viewed Some Hops
Some say marry money but my brother says big brains matter more
,◉ Confusion. Answer: Confusion is not a disease process or disease
state but rather a symptom. Confusion is an inability to think quickly
or coherently. A confused patient may be disoriented to time, place,
or person and usually demonstrates impairment of cognitive
functioning. It is usually demonstrated by inappropriate reactions to
environmental stimuli, may arise suddenly or gradually, and may be
either temporary or irreversible. Stressful events, lack of sleep or
food, or sensory deprivation may precipitate confusion. Age is not a
reliable predictor; however, older adults are most at risk because of
polypharmacy (multiple prescription drugs), the aging process,
preexisting dementia, and the presence of chronic disease.
◉ Confusion: Differential Diagnosis. Answer: Confusion is a key sign
of neurologic disorders. The physical examination will provide clues.
One major difficulty lies in differentiating symptoms of delirium
from dementia. The clinician must establish whether the patient has
delirium, a delirium superimposed on another condition such as
Alzheimer's disease (AD), or another neurocognitive disorder apart
from delirium, such as dementia. Once the disease has been
identified and treatment started, the symptom of confusion may
disappear.
Differential diagnoses for confusion involve almost all body systems
◉ Dementia. Answer: Dementia is a decline in mental functioning,
affecting memory, cognition, language, and personality. persistent or
more severe confusion, with or without psychomotor hyperactivity
,characterized by a significant time span between symptom
appearance and death, defines dementia.
Delirium is An acute transient disturbance in thought process
Clinically significant confusion states in older patients may lead the
provider to suspect dementias such as AD; multi-infarct dementia as
a result of CVA, or vascular dementia; depression, which can cause
dementia; or excessive consumption of alcohol or drugs, which can
also cause dementia.
◉ Dementia: Continued. Answer: The Diagnostic and Statistical
Manual of Mental Disorders (fifth edition; American Psychiatric
Association, 2013) 6th ed, now available. defines dementia as
significant cognitive impairment that represents a significant decline
from a previous level of functioning.
Cognitive impairment refers to a decline in at least one of the
following cognitive domains:
Language
executive function
Attention
perceptual-motor function
social cognition
Learning
Memory
, The disturbance must interfere with independence in everyday
activities and not be better accounted for by another neurocognitive
disorder.
◉ Dementia: Continued. Answer: Treatment for dementia is disease
specific. Treatment of AD consists of both pharmacologic and
nonpharmacologic measures. Pharmacologic therapy consists
primarily of Menantine (Namenda).
memantine and cholinesterase inhibitors (such as donepezil and
rivastigmine) are both used for moderate to severe AD
the combination of both memantine and donepezil may be more
effective than either alone
Nonpharmacologic measures include cognitive rehabilitation,
exercise, and occupational therapy
Antipsychotic drugs such as haloperidol (Haldol), quetiapine
(Seroquel), risperidone (Risperdal), olanzapine (Zyprexa), and
aripiprazole (Abilify) continue to be used to treat agitation and
aggression, but there is limited evidence of clinical benefit. Caution
must be taken as to the risks of increased cerebrovascular events.
Risperidone is the only recommended antipsychotic and should only
be used for 3 months.
Carbamazepine (Tegretol) is an anticonvulsant that may control
impulsivity and aggression
Patients with panic disorders may respond to lorazepam (Ativan) or
oxazepam (Serax).
