NR 667 CEA FNP Capstone Practicum and Intensive
Final Exam – Chamberlain
1. The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a
pulse deficit by auscultating the patient's heart while watch- ing the EKG rhythm. Where
would the S1 heart sounds correlate with the electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
Answer> Peak of the R wave.
2. Michael, a 72 year old male patient who previously presented with stable cardiac-type
chest pain has underwent a stress test. He presents today to review the stress test results,
which show EKG findings of ST segment de- pression during the exam in leads V3 and V4 as
well as some concurrent chest discomfort. Based on these findings, which of the following
are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction
Answer> Check for thyroid dysfunction
3. While examining a 53 year old female patient, you auscultate abnormal breath sounds over
all fields, and now assess transmission of voice sounds by having the patient say "ee" while
auscultating the chest with the diaphragm
,of your stethoscope. Normally, you should auscultate a muffled "e" sound,
however, you hear hear a nasally "a" sound. Which one of the following will you document is
present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
Answer> Positive for egophony
4. During a post-hospital discharge visit, you notice your 71 year old female
patient has been diagnosed with a "new murmur" found by the hospitalist dur- ing their recent
hospitalization for CHF exacerbation. In evaluating the patient, during which phase of the
cardiac cycle would you anticipate auscultation of a S3 or S4 heart sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole
Answer> Diastole
5. The point of maximum impulse (PMI) is MOST often palpable in healthy adults when
positioned in the supine or left lateral decubitus position. Which one of the following
locations is most commonly described as the PMI in a healthy adult?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line.
Answer> Left 5th intercostal space, midclavicular line
6. While assessing the 19 year old patient for a new onset cough, the nurse practitioner
may inspect, auscultate, palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical
examination?
*To assist with the confirmation of cardiac origin of angina.
,*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated
Answer> To identify if underlying tissue are air-filled, fluid-filled or consolidated
7. Your 42 year old male patient has been referred to your clinic for establish- ing care and on
his intake survey, you note he has documented diagnosis
of interstitial lung disease. You have decided to perform a diaphragmatic excursion test on
the patient. Which one of the following results would you expect to see in this patient?
*Approximately equal level of change in the descent of the diaphragm bi- laterally during
maximal inspiration and expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though often
much less on the right side due to the location of the heart and great vessels.
*Much greater descent of the diaphragm on the right side due to the liver present (two-three
times larger).
*Absent or no change in movement of the diaphragm noted between full inspi- ration and full
expiration measurement.
Answer> Approximately equal level of change in the descent of the diaphragm bilaterally during
maximal inspiration and expiration. with a decreased overall inspiratory capacity
8. Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years
and is here for a history and physical examination. While examining the head and face, you
see your patient has nonpitting periorbital
edema, particularly underneath their eyes and very dry, thinned hair, including the lateral third
of eyebrows (as pictured below
Sparse hairline, thin lateral eyebrows, Periobital
edema). Which one of the folowing would you
expect to
cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
Answer> Severe hypothyroidism
, 9. A40 year old, female, African American patient presents for history and physical. Upon
your initial assessment, you notice she has severe exophthal- mos as pictured below. Which
one of the following diagnoses below would be the highest on your differential diagnose of this
physical examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Answer> Hyperthyroidism.
10. Your patient with a suspected diagnosis of COPD has been seen by pul- monology and
has underwent a pulmonary function test (PFT) with spirom- etry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient in
a
follow-up visit at which time the patient asks what the study was evaluating. To describe the
PFT to the patient in more useful terms, you state that the large inspiration of air to the
furthest extent they could reasonably accomplish followed by a full exhalation is referred to as
which of the following measure- ments during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity.
Answer> Forced Vital Capacity.
11. Your 32 year old female patient presented4for
/ 35
a routine health exam states
they have a diagnoses of hyperthyroidism by another
provider a year ago. In addition to evaluation with TSH and T4 labwork, which of the following
represent typical signs of hyperthyroidism expected on your exam of this patient?
*Hypersomnia
*Tachycardia.
*Lethargy.
*Recent unplanned weight gain.
Final Exam – Chamberlain
1. The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a
pulse deficit by auscultating the patient's heart while watch- ing the EKG rhythm. Where
would the S1 heart sounds correlate with the electrocardiographic waves?
*At the end of the T wave.
*At the start of the T wave.
*Peak of the R wave.
*At the start of the P wave.
Answer> Peak of the R wave.
2. Michael, a 72 year old male patient who previously presented with stable cardiac-type
chest pain has underwent a stress test. He presents today to review the stress test results,
which show EKG findings of ST segment de- pression during the exam in leads V3 and V4 as
well as some concurrent chest discomfort. Based on these findings, which of the following
are NOT priority medical decisions?
*Prescribe metoprolol (Lopressor) 12.5mg PO BID
*Prescribe aspirin 81mg PO daily
*Refer to cardiology for angiography
• Check for thyroid dysfunction
Answer> Check for thyroid dysfunction
3. While examining a 53 year old female patient, you auscultate abnormal breath sounds over
all fields, and now assess transmission of voice sounds by having the patient say "ee" while
auscultating the chest with the diaphragm
,of your stethoscope. Normally, you should auscultate a muffled "e" sound,
however, you hear hear a nasally "a" sound. Which one of the following will you document is
present?
*Positive stereognosis.
*Positive for egophony.
*Negative for bronchophony.
*Negative for egophony
Answer> Positive for egophony
4. During a post-hospital discharge visit, you notice your 71 year old female
patient has been diagnosed with a "new murmur" found by the hospitalist dur- ing their recent
hospitalization for CHF exacerbation. In evaluating the patient, during which phase of the
cardiac cycle would you anticipate auscultation of a S3 or S4 heart sound?
*Diastole
*53 in systole while S4 in diastole
*Systole
*S4 in diastole while S3 in systole
Answer> Diastole
5. The point of maximum impulse (PMI) is MOST often palpable in healthy adults when
positioned in the supine or left lateral decubitus position. Which one of the following
locations is most commonly described as the PMI in a healthy adult?
*Left 2nd intercostal space, midaxillary line.
*Left 5th intercostal space, midclavicular line.
*Right 4th intercostal space, midaxillary line.
*Right 2nd intercostal space, midclavicular line.
Answer> Left 5th intercostal space, midclavicular line
6. While assessing the 19 year old patient for a new onset cough, the nurse practitioner
may inspect, auscultate, palpate, and/or percuss.
How does performing percussion of the thorax assist the provider during the physical
examination?
*To assist with the confirmation of cardiac origin of angina.
,*To assess for deep-seated lesion and tumors.
*To assess for any pain or discomfort prior to palpitation of the chest wall.
*To identify if underlying tissue are air-filled, fluid-filled or consolidated
Answer> To identify if underlying tissue are air-filled, fluid-filled or consolidated
7. Your 42 year old male patient has been referred to your clinic for establish- ing care and on
his intake survey, you note he has documented diagnosis
of interstitial lung disease. You have decided to perform a diaphragmatic excursion test on
the patient. Which one of the following results would you expect to see in this patient?
*Approximately equal level of change in the descent of the diaphragm bi- laterally during
maximal inspiration and expiration. with a decreased overall inspiratory capacity.
*Ascension of 8-12 inches of the diaphragm noted bilaterally on expiration, though often
much less on the right side due to the location of the heart and great vessels.
*Much greater descent of the diaphragm on the right side due to the liver present (two-three
times larger).
*Absent or no change in movement of the diaphragm noted between full inspi- ration and full
expiration measurement.
Answer> Approximately equal level of change in the descent of the diaphragm bilaterally during
maximal inspiration and expiration. with a decreased overall inspiratory capacity
8. Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years
and is here for a history and physical examination. While examining the head and face, you
see your patient has nonpitting periorbital
edema, particularly underneath their eyes and very dry, thinned hair, including the lateral third
of eyebrows (as pictured below
Sparse hairline, thin lateral eyebrows, Periobital
edema). Which one of the folowing would you
expect to
cause this finding?
*Severe hypothyroidism
*Addison's disease
*Grave's disease
*Alzhemiers.
Answer> Severe hypothyroidism
, 9. A40 year old, female, African American patient presents for history and physical. Upon
your initial assessment, you notice she has severe exophthal- mos as pictured below. Which
one of the following diagnoses below would be the highest on your differential diagnose of this
physical examination finding? (eyes bulging out of her head)
*Bilateral conjunctivitis.
*Hyperthyroidism.
*hypothyroidism
*myexedma
Answer> Hyperthyroidism.
10. Your patient with a suspected diagnosis of COPD has been seen by pul- monology and
has underwent a pulmonary function test (PFT) with spirom- etry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient in
a
follow-up visit at which time the patient asks what the study was evaluating. To describe the
PFT to the patient in more useful terms, you state that the large inspiration of air to the
furthest extent they could reasonably accomplish followed by a full exhalation is referred to as
which of the following measure- ments during the PFT?
*Forced Expiratory Volume over 1 second (FEV1).
*Functional Reserve Capacity.
*Inspiratory Reserve
*Forced Vital Capacity.
Answer> Forced Vital Capacity.
11. Your 32 year old female patient presented4for
/ 35
a routine health exam states
they have a diagnoses of hyperthyroidism by another
provider a year ago. In addition to evaluation with TSH and T4 labwork, which of the following
represent typical signs of hyperthyroidism expected on your exam of this patient?
*Hypersomnia
*Tachycardia.
*Lethargy.
*Recent unplanned weight gain.
