NR509 MIDTERM EXAM TESTBANK 2 WITH 400
QUESTIONS & CORRECT ANSWERS LATEST
2026/2027
A 42-year-old female presents to the clinic with sudden onset of left eye pain and blurry
vision in the left eye. The nurse practitioner is using an ophthalmoscope to assess the
patient's left eye and notes an enlarged physiologic cup. This is indicative of which
diagnosis?
A) A normal physiologic cup
B) Papilledema
C) Chronic open-angle glaucoma
D) Chalazion
C
A 30-year-old male present to the ED with a sudden onset of dizziness when he got out
of bed today at 9:00 am. The patient denies vision changes, headache, weakness and
N/V. The patient states "It feels like the room is spinning". The patients CT head w/o
contrast showed no acute intracranial abnormality. Labs are unremarkable. The EKG
shows a normal sinus rhythm with a heart rate of 67. Blood pressure: 130/78 standing
up, 128/74 sitting down, 125/70 lying down. The patient was given 1 liter bolus of 0.9%
Normal saline intravenously & 25 mg Meclizine by mouth. The patient expresses relief
of symptoms with medication and fluids. The nurse practitioner discharges the patient
with a diagnosis of which of the following?
A) Meniere's disease
B) Orthostatic hypotension
C) Vertigo
D) Presyncope
C
The nurse practitioner is assessing a 25-year-old male with right ear pain and
tenderness. No drainage noted on exam. How does the nurse practitioner correctly
assess the patient's right ear using the otoscope?
A) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it upward,
forward, and slightly toward the head.
B) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it
downward and forward.
C) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it
downward and backward.
D) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it upward,
backward and slightly away from the head.
D
5. The nurse practitioner is assessing a 70-year-old female with a chief complaint of
decreased appetite and tongue soreness. The patient states "I also had some white
plaque on my tongue, but I was able to scrape some off". The patient is currently taking
steroids and antibiotics for pneumonia. At the end of the visit, the nurse practitioner
prescribes the patient Fluconazole (Diflucan). The nurse practitioner determines
learning has occurred if the patient states which of the following?
A) "The white stuff on my tongue is called leukoplakia"
,B) "I'll stop using my antibiotics"
C) "This fluconazole is used for my pneumonia"
D) "I'm going to take fluconazole for my candida infection"
D
,H.G., a 68-year-old male, is in your clinic today for an initial physical. Vital signs for
today are PO temperature, 98.2 degrees F. HR 72 BPM. BP 178/95. SpO2 98% on
room air. Past medical history includes a hernia repair in 1997. Mr. H.G. is a poor
historian and admits to avoiding seeking medical treatment throughout his life. As an
ACNP, you recognize in the older adult the following:
Systolic blood pressure (SBP) tends to rise with aging
Systolic blood pressure (SBP) tends to lower with aging
It's common for older men to avoid medical treatment
H.G. is most likely "healthy" due to his lack of medical history
A
During your assessment with Mr. H.G., he expresses that over the last several years his
vision has been affecting him. He further explains that his ability to see "things" up close
appears "blurry", but becomes "clearer" when moved further away. With this
information, you suspect the following:
Cataracts
Myopia
Presbyopia
Macular degeneration
C
You continue to assess Mr. H.G., examining both ears. Based on the image below, you
note the following:
Screen Shot 2022-02-03 at 10.08.19 PM.png
The cone of light is at the 5 o'clock position indicating the right ear
The cone of light is at the 5 o'clock position indicating the left ear
The cone of light is at the 7 o'clock position indicating the right ear
The cone of light is not visible due to cerumen
A
In completion of your exam on Mr. H.G., the next plan of action is the recommendation
for a set of baseline labs. As an ANP, you must use the approved medical abbreviations
and acronyms. You recommend the following:
CBC, CMP, HBA1C, LP, TP, and Vitamin D
CDC, CMP, HbA1c, Lipid and Thyroid Panel, and Vitamin D
CBC, CMP, HBA1C, L&T Panel, and Vitamin D
CBC, CMP, HbA1c, Lipid and Thyroid Panel, and Vitamin D
D
5. In conclusion of your physical exam and assessment of Mr. H.G., you ask if there are
any questions or concerns. H.G. asks you about an Advance Directive and if this is a
necessary document and would like more information. As the ANP, you state:
"No." "You're still young and do not require this type of planning."
"Yes." "It's never too early to start planning ahead."
"I don't like to talk about this topic with patients."
"No." "You only need that if you are hospitalized."
B
A 75-year male presents to the clinic stating that he is having visual problems in both
eyes, and he started to lose vision slowly, especially when he looks straight ahead. As a
health care provider what will you tell him?
, a) This is common with aging, don't worry.
b) I will refer you to an ophthalmologist to rule out macular degeneration.
c) This is cataracts.
d) This is hyperopia (farsightedness).
B
A parent brings their one-year-old to the clinic because they notice a lump on the right
side of the neck. The lump seems to be getting bigger and the antibiotics were not
effective as an APRN what will you do?
a) Tell the parents that is okay, and it will go away if it doesn't go away come back in a
week.
b) Refer the one-year-old to the HEENT for further evaluation.
c) Prescribe a different antibiotic.
d) Tell the parent that is a lymph node that is swollen and is normal in children.
B
A 32-year-old female was extubated after an asthma exacerbation. The APRN is
teaching a student nurse to be aware for which ominous sign that could be the cause of
subglottic or tracheal obstruction?
a) High pitches musical sound known as stridor
b) Wheezes
c) Diminish lung sounds
d) Rhonchi
A
The APRN needs to be aware that certain medications could cause permanent hearing
loss. While precepting a new APRN she will further educate the new APRN if she
makes the following statement?
a) Gentamicin could cause permanent hearing loss.
b) Cisplatin could cause permanent hearing loss.
c) Carboplatin could cause permanent hearing loss.
d) Lasix, NSAIDS, and quinines could cause permanent hearing loss.
D
A 44-year male comes to the clinic stating that he has hoarseness for more than 3
months. He states that he feels pain and lost weight. Denies any alcohol, smoking or
drug use. What is the possible differential diagnosis?
a) Environmental Allergies
b) Vocal cord nodules
c) Viral infection
d) Bacterial infection
B
. A 21-year-old homeless male presents to the clinic with complaints of fatigue,
weakness, fever, chills, weight loss and generalized pain. As the nurse practitioner
student, name the category to which the generalized symptoms pertain to.
a. General survey
b. General appearance
c. Appearance
d. Constitutional symptoms
D
QUESTIONS & CORRECT ANSWERS LATEST
2026/2027
A 42-year-old female presents to the clinic with sudden onset of left eye pain and blurry
vision in the left eye. The nurse practitioner is using an ophthalmoscope to assess the
patient's left eye and notes an enlarged physiologic cup. This is indicative of which
diagnosis?
A) A normal physiologic cup
B) Papilledema
C) Chronic open-angle glaucoma
D) Chalazion
C
A 30-year-old male present to the ED with a sudden onset of dizziness when he got out
of bed today at 9:00 am. The patient denies vision changes, headache, weakness and
N/V. The patient states "It feels like the room is spinning". The patients CT head w/o
contrast showed no acute intracranial abnormality. Labs are unremarkable. The EKG
shows a normal sinus rhythm with a heart rate of 67. Blood pressure: 130/78 standing
up, 128/74 sitting down, 125/70 lying down. The patient was given 1 liter bolus of 0.9%
Normal saline intravenously & 25 mg Meclizine by mouth. The patient expresses relief
of symptoms with medication and fluids. The nurse practitioner discharges the patient
with a diagnosis of which of the following?
A) Meniere's disease
B) Orthostatic hypotension
C) Vertigo
D) Presyncope
C
The nurse practitioner is assessing a 25-year-old male with right ear pain and
tenderness. No drainage noted on exam. How does the nurse practitioner correctly
assess the patient's right ear using the otoscope?
A) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it upward,
forward, and slightly toward the head.
B) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it
downward and forward.
C) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it
downward and backward.
D) Straighten the right ear canal, grasping the auricle firmly but gently, pulling it upward,
backward and slightly away from the head.
D
5. The nurse practitioner is assessing a 70-year-old female with a chief complaint of
decreased appetite and tongue soreness. The patient states "I also had some white
plaque on my tongue, but I was able to scrape some off". The patient is currently taking
steroids and antibiotics for pneumonia. At the end of the visit, the nurse practitioner
prescribes the patient Fluconazole (Diflucan). The nurse practitioner determines
learning has occurred if the patient states which of the following?
A) "The white stuff on my tongue is called leukoplakia"
,B) "I'll stop using my antibiotics"
C) "This fluconazole is used for my pneumonia"
D) "I'm going to take fluconazole for my candida infection"
D
,H.G., a 68-year-old male, is in your clinic today for an initial physical. Vital signs for
today are PO temperature, 98.2 degrees F. HR 72 BPM. BP 178/95. SpO2 98% on
room air. Past medical history includes a hernia repair in 1997. Mr. H.G. is a poor
historian and admits to avoiding seeking medical treatment throughout his life. As an
ACNP, you recognize in the older adult the following:
Systolic blood pressure (SBP) tends to rise with aging
Systolic blood pressure (SBP) tends to lower with aging
It's common for older men to avoid medical treatment
H.G. is most likely "healthy" due to his lack of medical history
A
During your assessment with Mr. H.G., he expresses that over the last several years his
vision has been affecting him. He further explains that his ability to see "things" up close
appears "blurry", but becomes "clearer" when moved further away. With this
information, you suspect the following:
Cataracts
Myopia
Presbyopia
Macular degeneration
C
You continue to assess Mr. H.G., examining both ears. Based on the image below, you
note the following:
Screen Shot 2022-02-03 at 10.08.19 PM.png
The cone of light is at the 5 o'clock position indicating the right ear
The cone of light is at the 5 o'clock position indicating the left ear
The cone of light is at the 7 o'clock position indicating the right ear
The cone of light is not visible due to cerumen
A
In completion of your exam on Mr. H.G., the next plan of action is the recommendation
for a set of baseline labs. As an ANP, you must use the approved medical abbreviations
and acronyms. You recommend the following:
CBC, CMP, HBA1C, LP, TP, and Vitamin D
CDC, CMP, HbA1c, Lipid and Thyroid Panel, and Vitamin D
CBC, CMP, HBA1C, L&T Panel, and Vitamin D
CBC, CMP, HbA1c, Lipid and Thyroid Panel, and Vitamin D
D
5. In conclusion of your physical exam and assessment of Mr. H.G., you ask if there are
any questions or concerns. H.G. asks you about an Advance Directive and if this is a
necessary document and would like more information. As the ANP, you state:
"No." "You're still young and do not require this type of planning."
"Yes." "It's never too early to start planning ahead."
"I don't like to talk about this topic with patients."
"No." "You only need that if you are hospitalized."
B
A 75-year male presents to the clinic stating that he is having visual problems in both
eyes, and he started to lose vision slowly, especially when he looks straight ahead. As a
health care provider what will you tell him?
, a) This is common with aging, don't worry.
b) I will refer you to an ophthalmologist to rule out macular degeneration.
c) This is cataracts.
d) This is hyperopia (farsightedness).
B
A parent brings their one-year-old to the clinic because they notice a lump on the right
side of the neck. The lump seems to be getting bigger and the antibiotics were not
effective as an APRN what will you do?
a) Tell the parents that is okay, and it will go away if it doesn't go away come back in a
week.
b) Refer the one-year-old to the HEENT for further evaluation.
c) Prescribe a different antibiotic.
d) Tell the parent that is a lymph node that is swollen and is normal in children.
B
A 32-year-old female was extubated after an asthma exacerbation. The APRN is
teaching a student nurse to be aware for which ominous sign that could be the cause of
subglottic or tracheal obstruction?
a) High pitches musical sound known as stridor
b) Wheezes
c) Diminish lung sounds
d) Rhonchi
A
The APRN needs to be aware that certain medications could cause permanent hearing
loss. While precepting a new APRN she will further educate the new APRN if she
makes the following statement?
a) Gentamicin could cause permanent hearing loss.
b) Cisplatin could cause permanent hearing loss.
c) Carboplatin could cause permanent hearing loss.
d) Lasix, NSAIDS, and quinines could cause permanent hearing loss.
D
A 44-year male comes to the clinic stating that he has hoarseness for more than 3
months. He states that he feels pain and lost weight. Denies any alcohol, smoking or
drug use. What is the possible differential diagnosis?
a) Environmental Allergies
b) Vocal cord nodules
c) Viral infection
d) Bacterial infection
B
. A 21-year-old homeless male presents to the clinic with complaints of fatigue,
weakness, fever, chills, weight loss and generalized pain. As the nurse practitioner
student, name the category to which the generalized symptoms pertain to.
a. General survey
b. General appearance
c. Appearance
d. Constitutional symptoms
D
