Advanced Health Assessment CEA Prep Nurse
practitioner (NP) Verified Multiple Choice and
Conceptual Actual Exam Questions With Reviewed
100% Correct Detailed Answers & Rationales
Guaranteed Pass!!Current Update
1. 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?
*Administer intravenous tPA
*Start anticoagulation therapy
*Perform a CT scan of the head
*Administer aspirin - ANSWER Perform a CT scan of the head
Rationale: A CT scan may be performed in cases of right-sided weakness and
difficulty speaking (aphasia) to assess for possible acute neurological conditions,
such as stroke or intracranial hemorrhage. Stroke is a leading cause of sudden
onset right-sided weakness and aphasia. A CT scan of the brain is often the initial
imaging test used to assess for acute ischemic stroke (due to a blocked blood
vessel) or hemorrhagic stroke (due to bleeding into the brain).
2. A 70-year-old man presents with sudden confusion, agitation, and
hallucinations. He has a history of hypertension and diabetes. His laboratory tests
reveal hyponatremia. What is the most likely diagnosis?
*Delirium tremens
,*Stroke
*Acute renal failure
*Hyponatremic encephalopathy - ANSWER Hyponatremic encephalopathy
Rationale: Hyponatremic encephalopathy manifests with neurological symptoms
such as confusion, lethargy, seizures, and in severe cases, coma. These symptoms
occur due to the brain's inability to maintain its normal fluid balance in the
presence of low sodium levels. Both hypertension and diabetes often require
multiple medications for management. Some medications used to treat these
conditions or their complications can contribute to electrolyte disturbances,
including hyponatremia.
3. A 45-year-old man presents with episodes of feeling extremely happy and
energetic for a few days, followed by periods of intense sadness and hopelessness.
During the high periods, he engages in risky behaviors and has little need for
sleep. What is the most likely diagnosis?
*Cyclothymic disorder
*Bipolar II disorder
*Bipolar I disorder
*Major depressive disorder - ANSWER Bipolar I disorder
Rationale: Bipolar I Disorder is characterized by extreme mood swings, including
manic, depressive, and sometimes mixed episodes. Recognizing the symptoms
and seeking early intervention is crucial for effective management. Treatment
typically involves a combination of medications, psychotherapy, and lifestyle
modifications to stabilize mood and improve quality of life.
4. First line therapy for patients with a new diagnosis of anxiety includes which of
the following strategies?
,*Treating with twice a day low-dose lorazepam prophylactically
*Providing a 90-day prescription of moderate-dose valium PRN for anxiety
*Consulting a counselor for evaluation in 3 months
*Prescribing a low-dose SSRI - ANSWER Prescribing a low-dose SSRI
Rationale: The safest choice provided is to prescribe a low-dose SSRI. Many
patients with anxiety are primarily suffering from depression. A 90-day
prescription of a benzodiazepine is not prudent prescription practice, nor is a
prophylactic scheduled treatment strategy with benzodiazepines. Consultation for
a counselor should be as soon as possible, within a few days at most if possible.
5. While rounding, your patient is experiencing visual hallucinations. The patient
should be responded to in which of the following ways?
*Do not address that they are hallucination whatsoever
*Encourage the patient to get out of the chair to show you where the
hallucination is located in more detail
*Play into the hallucination to bond with the patient
*Reorient the patient to the fact that you do not see the hallucination and that
they are in fact seeing things that are not real - ANSWER Reorient the patient
to the fact that you do not see the hallucination and that they are in fact seeing
things that are not real
Rationale: Although it may be uncomfortable, it is important to reorient the
patient that they are experiencing a hallucination for both reorienting them and
helping provide a safe environment. It is not useful to confuse the patient by
pretending you see the hallucination and the patient should not get out of their
chair since they represent an increased fall risk due to their altered sensorium.
, 6. The nurse practitioner prescribes amitriptyline (Elavil) for a patient with
neuropathic pain secondary to diabetes mellitus. On follow-up, the patient
presents with urine retention and dry mouth. The practitioner should:
*discontinue amitriptyline (Elavil) and begin gabapentin (Neurontin).
*discontinue amitriptyline (Elavil) and begin ibuprofen (Motrin).
*refer to physical therapy.
*start methocarbamol (Robaxin). - ANSWER discontinue amitriptyline (Elavil)
and begin gabapentin (Neurontin).
Rationale: Elavil (Amitriptyline) is a tricyclic antidepressant (TCA) commonly used
to treat depression, anxiety disorders, and certain types of chronic pain. While
effective for these conditions, amitriptyline can cause several side effects,
including urinary retention. Amitriptyline has strong anticholinergic properties,
meaning it blocks the action of acetylcholine, a neurotransmitter involved in
muscle contractions
7. The use of which class of anti-anxiety medication should be limited to short
duration of lowest dose possible?
*Antihistamines
*Benzodiazepines
*H2 Receptor antagonists
*NSAIDs - ANSWER Benzodiazepines
Rationale: Benzodiazepines have a considerable risk for dependence and should
be limited to as short of a duration of therapy as possible at the lowest dose
possible. The remaining options are all non-habit forming.
8. Treatment for extrapyramidal symptoms should include which of the following?
practitioner (NP) Verified Multiple Choice and
Conceptual Actual Exam Questions With Reviewed
100% Correct Detailed Answers & Rationales
Guaranteed Pass!!Current Update
1. 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?
*Administer intravenous tPA
*Start anticoagulation therapy
*Perform a CT scan of the head
*Administer aspirin - ANSWER Perform a CT scan of the head
Rationale: A CT scan may be performed in cases of right-sided weakness and
difficulty speaking (aphasia) to assess for possible acute neurological conditions,
such as stroke or intracranial hemorrhage. Stroke is a leading cause of sudden
onset right-sided weakness and aphasia. A CT scan of the brain is often the initial
imaging test used to assess for acute ischemic stroke (due to a blocked blood
vessel) or hemorrhagic stroke (due to bleeding into the brain).
2. A 70-year-old man presents with sudden confusion, agitation, and
hallucinations. He has a history of hypertension and diabetes. His laboratory tests
reveal hyponatremia. What is the most likely diagnosis?
*Delirium tremens
,*Stroke
*Acute renal failure
*Hyponatremic encephalopathy - ANSWER Hyponatremic encephalopathy
Rationale: Hyponatremic encephalopathy manifests with neurological symptoms
such as confusion, lethargy, seizures, and in severe cases, coma. These symptoms
occur due to the brain's inability to maintain its normal fluid balance in the
presence of low sodium levels. Both hypertension and diabetes often require
multiple medications for management. Some medications used to treat these
conditions or their complications can contribute to electrolyte disturbances,
including hyponatremia.
3. A 45-year-old man presents with episodes of feeling extremely happy and
energetic for a few days, followed by periods of intense sadness and hopelessness.
During the high periods, he engages in risky behaviors and has little need for
sleep. What is the most likely diagnosis?
*Cyclothymic disorder
*Bipolar II disorder
*Bipolar I disorder
*Major depressive disorder - ANSWER Bipolar I disorder
Rationale: Bipolar I Disorder is characterized by extreme mood swings, including
manic, depressive, and sometimes mixed episodes. Recognizing the symptoms
and seeking early intervention is crucial for effective management. Treatment
typically involves a combination of medications, psychotherapy, and lifestyle
modifications to stabilize mood and improve quality of life.
4. First line therapy for patients with a new diagnosis of anxiety includes which of
the following strategies?
,*Treating with twice a day low-dose lorazepam prophylactically
*Providing a 90-day prescription of moderate-dose valium PRN for anxiety
*Consulting a counselor for evaluation in 3 months
*Prescribing a low-dose SSRI - ANSWER Prescribing a low-dose SSRI
Rationale: The safest choice provided is to prescribe a low-dose SSRI. Many
patients with anxiety are primarily suffering from depression. A 90-day
prescription of a benzodiazepine is not prudent prescription practice, nor is a
prophylactic scheduled treatment strategy with benzodiazepines. Consultation for
a counselor should be as soon as possible, within a few days at most if possible.
5. While rounding, your patient is experiencing visual hallucinations. The patient
should be responded to in which of the following ways?
*Do not address that they are hallucination whatsoever
*Encourage the patient to get out of the chair to show you where the
hallucination is located in more detail
*Play into the hallucination to bond with the patient
*Reorient the patient to the fact that you do not see the hallucination and that
they are in fact seeing things that are not real - ANSWER Reorient the patient
to the fact that you do not see the hallucination and that they are in fact seeing
things that are not real
Rationale: Although it may be uncomfortable, it is important to reorient the
patient that they are experiencing a hallucination for both reorienting them and
helping provide a safe environment. It is not useful to confuse the patient by
pretending you see the hallucination and the patient should not get out of their
chair since they represent an increased fall risk due to their altered sensorium.
, 6. The nurse practitioner prescribes amitriptyline (Elavil) for a patient with
neuropathic pain secondary to diabetes mellitus. On follow-up, the patient
presents with urine retention and dry mouth. The practitioner should:
*discontinue amitriptyline (Elavil) and begin gabapentin (Neurontin).
*discontinue amitriptyline (Elavil) and begin ibuprofen (Motrin).
*refer to physical therapy.
*start methocarbamol (Robaxin). - ANSWER discontinue amitriptyline (Elavil)
and begin gabapentin (Neurontin).
Rationale: Elavil (Amitriptyline) is a tricyclic antidepressant (TCA) commonly used
to treat depression, anxiety disorders, and certain types of chronic pain. While
effective for these conditions, amitriptyline can cause several side effects,
including urinary retention. Amitriptyline has strong anticholinergic properties,
meaning it blocks the action of acetylcholine, a neurotransmitter involved in
muscle contractions
7. The use of which class of anti-anxiety medication should be limited to short
duration of lowest dose possible?
*Antihistamines
*Benzodiazepines
*H2 Receptor antagonists
*NSAIDs - ANSWER Benzodiazepines
Rationale: Benzodiazepines have a considerable risk for dependence and should
be limited to as short of a duration of therapy as possible at the lowest dose
possible. The remaining options are all non-habit forming.
8. Treatment for extrapyramidal symptoms should include which of the following?
