NR 667: WEEK 1: PRACTICE EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
1) Which nationality is four times as likely as Caucasians to be diagnosed with kidney
disease?
A) African Americans
B) Native Alaskans
C) Pacific Islanders
D) Eastern Europeans -- Answer ✔✔ African Americans
2) A 70-year-old man presents with acute onset of right-sided weakness and
difficulty speaking. His symptoms started 2 hours ago. What is the most
appropriate initial intervention?
A) Perform a CT scan of the head
B) Administer intravenous tPA
C) Administer aspirin
D) Start anticoagulation therapy -- Answer ✔✔ Perform a CT scan of the
head
3) A patient presents with left temporal-parietal headache that has been increasing
in intensity and frequency over the past 2 weeks. Coughing increases the pain.
Past history is non-contributory. Today, the patient began having difficulty forming
, words. Physical examination is normal except for some blurring of the disc
margins on fundoscopic examination. The best course of action involves:
A) Schlotz tonometry
B) Administration of sumatriptan (Imitrex) 6 mg SC
C) X-ray of sinuses
D) Immediate referral to neurosurgeon -- Answer ✔✔ Immediate referral
to neurosurgeon
4) Which of the following is characteristic of Lewy body dementia?
A) Echolalia
B) Depression
C) Diplopia
D) Parkinsonian features -- Answer ✔✔ Parkinsonian features
5) Patients who take chronic anti-seizure medication should be notified of which risk
of abrupt change or discontinuation of these medications?
A) Decreased seizure threshold
B) Increased seizure threshold
C) Flu-like symptoms
D) Discontinuation syndrome -- Answer ✔✔ Decreased seizure threshold
6) A patient is newly diagnosed with multiple sclerosis. Treatment includes
prednisone with physical therapy. The nurse practitioner advises the patient to
begin disease- modifying therapy:
A) if symptoms worsen.
B) if MRI of the brain shows a new lesion.
C) as soon as possible.
D) if symptoms remain the same for 3 months. -- Answer ✔✔ as soon as
possible.
7) Ischemic strokes are often caused by:
A) Atherosclerosis
B) Hypertensive arteriolar disease
C) Amyloid deposition
D) Arteriovenous malformation -- Answer ✔✔ Atherosclerosis
,8) A patient who presents to your clinic with an acute change in facial symmetry,
inability to speak clearly and unilateral muscular weakness should be transported
for evaluation immediately as treatment for embolic stroke with tPA within which
timeframe?
A) Less than 4.5 hrs
B) Less than 8 hrs
C) Less than 24 hrs
D) Less than 6 hrs -- Answer ✔✔ Less than 4.5 hrs
9) Patients who exhibit a positive Kernig's sign should be evaluated for which
potential illness?
A) Myocarditis
B) Appendicitis
C) Meningitis
D) Pericarditis -- Answer ✔✔ Meningitis
10) Your patient has been noticing progressively worsening muscular weakness over
the past 15 months to the point he is not able to stand and is effectively
wheelchair bound. Which of the following diagnoses can reasonably be excluded?
A) Myasthenia Gravis
B) Descending Guillain-Barre
C) Anterior cord syndrome
D) Multiple Sclerosis -- Answer ✔✔ Descending Guillain-Barre
11) The use of GABA-agonizing drugs is likely going to have which effect on seizure
threshold?
A) Decrease
B) No change
C) Increase
D) None of the above -- Answer ✔✔ Increase
12) A late adolescent female is requesting information on HPV vaccine. Which of the
following statements indicates need to further education?
, A) Three doses are required for effective immunity
B) The vaccine does not protect against all forms of STIs
C) The vaccine replaces the need for routine cervical cancer screening
D) I will still need to use other forms of protection with sexual
intercourse -- Answer ✔✔ The vaccine replaces the need for routine
cervical cancer screening
13) A nurse practitioner is evaluating an infant for possible colic. Which of the
following could indicate the need for a more extensive evaluation?
A) Onset at 4 weeks of age
B) Moist mucus membranes and flat fontanels
C) Stool negative for occult blood
D) 3-oz (85 g) weight gain over the past 2 weeks -- Answer ✔✔ 3-oz (85
g) weight gain over the past 2 weeks
14) A late adolescent is brought to the nurse practitioner's office by her mother, who
is concerned about her daughter's recent weight loss and the potential of purging
herself after meals. The daughter denies any self-induced vomiting, starvation or
excessive activity. History reveals that the daughter was consistently in the 50th
percentile for weight but is now in the 10th percentile. She does state that she
jogs 5 miles a day and is in good condition. In addition to a complete blood count
with differential, which of the following laboratory tests will be most helpful for
further assessment?
A) Electrolytes, fasting blood sugar
B) Electrolytes, FSH, stool for occult blood
C) Creatine phosphokinase, follicle-stimulating hormone (FSH)
D) Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis --
Answer ✔✔ Electrolytes, blood urea nitrogen (BUN)/creatinine,
urinalysis
15) At what age should a child typically be able to sit without support?
COMPLETE SOLUTIONS
1) Which nationality is four times as likely as Caucasians to be diagnosed with kidney
disease?
A) African Americans
B) Native Alaskans
C) Pacific Islanders
D) Eastern Europeans -- Answer ✔✔ African Americans
2) A 70-year-old man presents with acute onset of right-sided weakness and
difficulty speaking. His symptoms started 2 hours ago. What is the most
appropriate initial intervention?
A) Perform a CT scan of the head
B) Administer intravenous tPA
C) Administer aspirin
D) Start anticoagulation therapy -- Answer ✔✔ Perform a CT scan of the
head
3) A patient presents with left temporal-parietal headache that has been increasing
in intensity and frequency over the past 2 weeks. Coughing increases the pain.
Past history is non-contributory. Today, the patient began having difficulty forming
, words. Physical examination is normal except for some blurring of the disc
margins on fundoscopic examination. The best course of action involves:
A) Schlotz tonometry
B) Administration of sumatriptan (Imitrex) 6 mg SC
C) X-ray of sinuses
D) Immediate referral to neurosurgeon -- Answer ✔✔ Immediate referral
to neurosurgeon
4) Which of the following is characteristic of Lewy body dementia?
A) Echolalia
B) Depression
C) Diplopia
D) Parkinsonian features -- Answer ✔✔ Parkinsonian features
5) Patients who take chronic anti-seizure medication should be notified of which risk
of abrupt change or discontinuation of these medications?
A) Decreased seizure threshold
B) Increased seizure threshold
C) Flu-like symptoms
D) Discontinuation syndrome -- Answer ✔✔ Decreased seizure threshold
6) A patient is newly diagnosed with multiple sclerosis. Treatment includes
prednisone with physical therapy. The nurse practitioner advises the patient to
begin disease- modifying therapy:
A) if symptoms worsen.
B) if MRI of the brain shows a new lesion.
C) as soon as possible.
D) if symptoms remain the same for 3 months. -- Answer ✔✔ as soon as
possible.
7) Ischemic strokes are often caused by:
A) Atherosclerosis
B) Hypertensive arteriolar disease
C) Amyloid deposition
D) Arteriovenous malformation -- Answer ✔✔ Atherosclerosis
,8) A patient who presents to your clinic with an acute change in facial symmetry,
inability to speak clearly and unilateral muscular weakness should be transported
for evaluation immediately as treatment for embolic stroke with tPA within which
timeframe?
A) Less than 4.5 hrs
B) Less than 8 hrs
C) Less than 24 hrs
D) Less than 6 hrs -- Answer ✔✔ Less than 4.5 hrs
9) Patients who exhibit a positive Kernig's sign should be evaluated for which
potential illness?
A) Myocarditis
B) Appendicitis
C) Meningitis
D) Pericarditis -- Answer ✔✔ Meningitis
10) Your patient has been noticing progressively worsening muscular weakness over
the past 15 months to the point he is not able to stand and is effectively
wheelchair bound. Which of the following diagnoses can reasonably be excluded?
A) Myasthenia Gravis
B) Descending Guillain-Barre
C) Anterior cord syndrome
D) Multiple Sclerosis -- Answer ✔✔ Descending Guillain-Barre
11) The use of GABA-agonizing drugs is likely going to have which effect on seizure
threshold?
A) Decrease
B) No change
C) Increase
D) None of the above -- Answer ✔✔ Increase
12) A late adolescent female is requesting information on HPV vaccine. Which of the
following statements indicates need to further education?
, A) Three doses are required for effective immunity
B) The vaccine does not protect against all forms of STIs
C) The vaccine replaces the need for routine cervical cancer screening
D) I will still need to use other forms of protection with sexual
intercourse -- Answer ✔✔ The vaccine replaces the need for routine
cervical cancer screening
13) A nurse practitioner is evaluating an infant for possible colic. Which of the
following could indicate the need for a more extensive evaluation?
A) Onset at 4 weeks of age
B) Moist mucus membranes and flat fontanels
C) Stool negative for occult blood
D) 3-oz (85 g) weight gain over the past 2 weeks -- Answer ✔✔ 3-oz (85
g) weight gain over the past 2 weeks
14) A late adolescent is brought to the nurse practitioner's office by her mother, who
is concerned about her daughter's recent weight loss and the potential of purging
herself after meals. The daughter denies any self-induced vomiting, starvation or
excessive activity. History reveals that the daughter was consistently in the 50th
percentile for weight but is now in the 10th percentile. She does state that she
jogs 5 miles a day and is in good condition. In addition to a complete blood count
with differential, which of the following laboratory tests will be most helpful for
further assessment?
A) Electrolytes, fasting blood sugar
B) Electrolytes, FSH, stool for occult blood
C) Creatine phosphokinase, follicle-stimulating hormone (FSH)
D) Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis --
Answer ✔✔ Electrolytes, blood urea nitrogen (BUN)/creatinine,
urinalysis
15) At what age should a child typically be able to sit without support?
