CEA – Advanced Nursing Practice Quiz, Clinical Education Associates PMHNP Review, Practice
Questions and Exam Preparation Material
When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans in with the
right side of his head and frequently asks for things to be repeated. His daughter is very worried
that he has dementia or depression because he has also become increasingly isolated, as well as
increasingly irritable as he believes people are yelling at him out of frustration of not being
heard. The daughter is tearful, anxious, and frustrated. What should the PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter - correct answer
✔✔Examine the patient's ear canals
A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he had felt a
lump on his left testicle. He is concerned he has not had a physical exam in 10 years. What is the
best action by the PMHNP?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology - correct answer ✔✔Explore the reason for not having had a physical in so
long
In observing the appearance of the patient with depression and a history of systemic lupus
erythematosus, the PMHNP notices a lesion on the neck of the patient about the size of a pencil
eraser, flush with the skin, uniformly colored, with discrete borders, and consistent texture. The
PMHNP should:
, Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology - correct answer ✔✔Watch and wait
Which of the following best represent the physical exam maneuver known as Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg up to the chest. A positive
test occurs when pain prohibits elevation of the ipsilateral leg.
The examiner palpates in the right upper abdominal quadrant below the costal margin while the
patient breathes in. The test is positive if the examiner observes pain during inhalation.
Press and palpate deeply into the abdomen and release quickly observing for pain.
Ask the patient to bend at the knees while holding onto a rail, observe for a loss of balance. -
correct answer ✔✔The examiner palpates in the right upper abdominal quadrant below the
costal margin while the patient breathes in. The test is positive if the examiner observes pain
during inhalation.
Acute cholecystitis
What does the Murphy sign assess for - correct answer ✔✔Cholecystitis
A 26-year-old man has been on an antipsychotic. He requires further titration for control of
symptoms. Which of the following tests should be repeated?
EKG
Head CT scan
Questions and Exam Preparation Material
When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans in with the
right side of his head and frequently asks for things to be repeated. His daughter is very worried
that he has dementia or depression because he has also become increasingly isolated, as well as
increasingly irritable as he believes people are yelling at him out of frustration of not being
heard. The daughter is tearful, anxious, and frustrated. What should the PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter - correct answer
✔✔Examine the patient's ear canals
A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he had felt a
lump on his left testicle. He is concerned he has not had a physical exam in 10 years. What is the
best action by the PMHNP?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology - correct answer ✔✔Explore the reason for not having had a physical in so
long
In observing the appearance of the patient with depression and a history of systemic lupus
erythematosus, the PMHNP notices a lesion on the neck of the patient about the size of a pencil
eraser, flush with the skin, uniformly colored, with discrete borders, and consistent texture. The
PMHNP should:
, Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology - correct answer ✔✔Watch and wait
Which of the following best represent the physical exam maneuver known as Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg up to the chest. A positive
test occurs when pain prohibits elevation of the ipsilateral leg.
The examiner palpates in the right upper abdominal quadrant below the costal margin while the
patient breathes in. The test is positive if the examiner observes pain during inhalation.
Press and palpate deeply into the abdomen and release quickly observing for pain.
Ask the patient to bend at the knees while holding onto a rail, observe for a loss of balance. -
correct answer ✔✔The examiner palpates in the right upper abdominal quadrant below the
costal margin while the patient breathes in. The test is positive if the examiner observes pain
during inhalation.
Acute cholecystitis
What does the Murphy sign assess for - correct answer ✔✔Cholecystitis
A 26-year-old man has been on an antipsychotic. He requires further titration for control of
symptoms. Which of the following tests should be repeated?
EKG
Head CT scan
