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NR 667 EXAM QUESTIONS AND CORRECT ANSWERS

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Pass your NR 667 nurse practitioner exam with this comprehensive study guide featuring authentic practice questions and verified correct answers covering essential primary care and clinical management topics for family and adult-gerontology nurse practitioners. This resource covers neonatal hyperbilirubinemia (phototherapy initiation at 16 mg/dL), leukemia clinical presentation (sickle cells unusual), highest suicide risk (87-year-old male with chronic pain, hopelessness, insomnia), developmental dysplasia of the hip (Galeazzi and Klisic tests, Barlow/Ortolani for newborns), mitral valve prolapse (redundant leaflet, elongated chordae tendineae), serum ferritin for iron storage evaluation, aortic stenosis symptom progression (dizziness preceding syncope, cardiology referral), candesartan avoiding potassium supplements (hyperkalemia risk), basal insulin adjustment based on fasting AM glucose, hyperthyroidism and secondary hypertension (pheochromocytoma, Cushing's, neuroblastoma), rheumatic fever (immune response to Group A Strep, affects heart, CNS, joints), hearing screening in older adults (age 75, ACOVE criteria), pertussis diagnosis (cough 14 days, paroxysmal phase, 3-month duration), pneumonia treatment guidelines (amoxicillin 1g TID, doxycycline, azithromycin, fluoroquinolones for comorbidities), lisinopril-induced cough (5-20%, bradykinin mechanism), Streptococcus pneumoniae with rust-colored sputum, colon polyps progression to cancer (slow), HIV transmission during high viral load (early infection before symptoms), pregnancy heart sounds (venous hum, S3 from increased fluid), medications NOT associated with weight gain (metoprolol), inguinal hernia (scrotal heaviness worse at end of day, relieved by lying down), osteoarthritis first-line medication (ibuprofen, ACC recommendation), HIV and CD4 count (few conditions cause CD4 depletion besides HIV), new diabetes evaluation (non-fasting lipids least helpful), meniscal tear (knee locking, McMurray test positive click), mononucleosis with lymphocytosis, older adult diabetic glucose range (80-130 fasting, not below 80), infant reflexes (parachute reflex not present at 1 month), C. diff enzyme immunoassay results in 24 hours, undernutrition as most common nutritional syndrome in older adults, alcohol in older adults (1-2 drinks/day max due to decreased body mass), metformin monitoring (renal function, lactic acidosis risk), anosmia and cranial nerve I (olfactory), allopurinol contraindicated in acute gout (no role in inflammation), meta-analysis as experimental study, encopresis management (client/family education first), Medicare billing (NP can bill patient for remaining 20%), prostate cancer screening in African American males (PSA discussion starting age 40-45, screening at 50 if desired), and Mycoplasma pneumoniae with extrapulmonary manifestations. Perfect for FNP and AGNP students preparing for NR 667 and board certification exams.

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NR 667
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NR 667 EXAM QUESTIONS AND CORRECT ANSWERS




A 3 day old infant has a bilirubin level of 16mg/dl. What should be done? -
ans✅✅initiate phototherapy. This level is considered high intermediate;
because it is expected the bilirubin level will rise in the next few days,
phototherapy is most appropriate.


Leukemia may have varied clinical presentation. What presentation would be
unusual to have in a leukemia patient? - ans✅✅sickle shaped cells; leukemia is
characterized by failure in the bone marrow. Sickle cell anemia would not be
observed unless they also had sca


What patient is at highest risk for suicide? - ans✅✅87 yo male with chronic
pain; older adults and men are successful with death. Suicide is more likely in
patients with : hopelessness, insomnia, alcohol abuse, unremitting pain,
restlessness, impaired concentration.


A 4 mos. Old is suspected of having developmental dysplasia of the hip. What
test would best assess for this? - ans✅✅galeazzi and klisic: limited abduction
and apparent thigh length discrepency is a better indicator of ddh than is
instability after 3 months of age, barlow and ortolani maneuvers are tests used to
test hip instability in newborns until approx. 3 months old. Trendelenburg pelvic
test is to test for walking age children to test for hip weakness and is
characterized by unilateral hip dyspleasia.


Which mitral disorder results from redundancy of the mitral valve leaflet? -
ans✅✅mitral valve prolapse. Most common . Adult murmur. Valves annulus

, becomes enlarged in conjunction with elongated chordae tendonae (this is
degeneration of the mitral tissue.


Serum ferritin - ans✅✅demonstrates the amount of iron in storage. Helpful in
evaluating pts being treated for iron deficiency anemia.


A patient with aortic stenosis has been asymptomatic for decades and begins c/o
some dizziness c activity w/o chest pain or sob. - ans✅✅refer to cardiology; be
alert for s/s that precede syncope. Dizziness precedes syncompe, and the patient
is now presenting with symptoms of aortic stenosis.


A patient taking candesartan should avoid - ans✅✅k+ supplements.
Candesartan can produce hyperkalemia because the moa spares k+.


A patient taking long actin basal insulin has elevated blood glucose. What blood
sugars are important to evaluae and base insulin changes on - ans✅✅am
fasting. . Basal insulin mimics steady stream of insulin produced by the pancrease
throughout day. Should be based off of fastin am glucose check. The other blood
sugars reflect blood sugar in reflection to meals.


Hyperthyroidism may affect bp by increase sbp and dbp. It is also a common
cause of secondary htn> other endocrine disorders that do the same are: -
ans✅✅pheochromocytoma, cushings syndrome, neuroblastoma. All of these
are causes of secondary htn.


An immune response to strep a infection of the hear are - ans✅✅rheumatic
fever. Can also affect cns and joints. Most common age group affected is 5-15 yo.
Residual affects not felt until decades later.

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