FAMILY Nurse Practitioner Exam Questions And
Answers Verified 100% Correct
An 18-year-old man has no primary tetanus immuniza- tion series documented.
Which of the following repre- sents the immunization needed? A. three doses of
diphtheria, tetanus, and acellular pertussis (DTaP) vaccine 2 months apart
B. tetanus IG now and two doses of tetanus-diphtheria
(Td) vaccine 1 month apart
C. tetanus, diphtheria, and acellular pertussis (Tdap) vac- cine now with a dose of Td
vaccine in 1 and 6 months
D. Td vaccine as a single dose - ANSWER C
Which wound presents the greatest risk for tetanus infection?
A. a puncture wound obtained while gardening
B. a laceration obtained while trimming beef
C. a human bite
D. an abrasion obtained by falling on a sidewalk - ANSWER A
Tetanus is caused by - ANSWER Tetanus infection is caused by Clostridium tetani, an
anaerobic, gram-positive, spore-forming rod.
found in soil, especially manure.
enters through wound
tetanus sx - ANSWER systemic disease
painful muscle weakness
spasm (lockjaw)
10% mortality
most cases are adults over 50
Diptheria - ANSWER caused by Corynebacterium diphtheriae, a gram-negative
bacillus
typically transmitted from person- to-person contact via respiratory droplets or
cutaneous lesion.
This organism causes a severe illness involving the respiratory tract, including the
appearance of pseudomembranous pharyngitis and possible airway obstruction.
Owing to high immunization rates, a confirmed case of diphtheria has not been reported
,in the United States for more than a decade.
tetanus shot - ANSWER 3 dose
booster 10 years
if adult, need the 3 but 2 can be Td instead of Tdap
if minor wound and unclear vax hx give tet vax
if other wounds too give tet with immunoglob (TIG)
Usual treatment for an adult with acute hepatitis A includes:
A. interferon-alfa therapy.
B. high-dose ribavirin.
C. parenteral acyclovir.
D. supportive care. - ANSWER D
bad with coinfection of A and/or C can cause bad liver prob
Peak infectivity of persons with hepatitis A usually occurs:
A. before onset of jaundice.
B. at the time of maximum elevation of liver enzymes.
C. during the recovery period.
D. at the time of maximum disease-associated symptoms. - ANSWER A
peak HAV infectivity - ANSWER 2 wk period before onset of jaundice or elevation of
liver enzymes
when vax HAV before travel - ANSWER 4-6 wks if going to high rate country
how is polio transmitted - ANSWER fecal-oral
Vaccine associated paralytic poliomyeltitis - ANSWER when vax given orally, it is live,
a little comes out through stool and can be contagious. This is why oral is not done in
the US but is still used other places
Stages of change - ANSWER • Precontemplation: The patient is not interested in
change and might be unaware that the problem exists or minimizes the problem's
impact.
• Contemplation: The patient is considering change and looking at its positive and
negative aspects. The person often reports feeling "stuck" with the problem, unable to
figure out how to change to solve or minimize the health issue. • Preparation: The
,patient exhibits some change behaviors or thoughts and often reports feeling that he or
she does not have the tools to proceed.
• Action: The patient is ready to go forth with change, often takes concrete steps
to change, but is often inconsistent with carrying through.
• Maintenance/relapse: The patient learns to continue the change and has
adopted and embraced the healthy habit. Relapse can occur, however, and the person
learns to deal with backsliding.
You see a 48-year-old patient who started taking varenicline (Chantix) 4 weeks ago to
aid in smoking cessation. Which of the following is the most important question to ask
during today's visit?
A. "How many cigarettes a day are you currently smoking?"
B. "On a scale of 0 to 10, how strong is your desire to smoke?"
C. "Have you noticed any changes in your mood?"
D. "Are you having any trouble sleeping?"` - ANSWER C
Specifically, depressed mood, agitation, changes in behavior, suicidal ideation, and
suicide have been reported in patients attempting to quit smoking while using
varenicline. Patients should tell their healthcare provider about any history of
psychiatric illness before starting this medication; clinicians should also ask about
mental health history before starting this medication. Close monitoring for changes in
mood and behavior should follow.
You perform an extraocular movement test on a middle- aged patient. He is unable to
move his eyes upward and inward. This indicates a possibility of paralysis of CN:
A. II.
B. III.
C. V.
D. VI. - ANSWER B
Loss of corneal reflex is in part seen in dysfunction of CN:
A. III. B. IV. C. V. D. VI. - ANSWER C
CN 1-6 - ANSWER • CN I—Olfactory: You have one nose, where CN I resides. Its
function contributes to the sense of smell.
• CN II—Optic: You have two eyes, where you will find CN II. Function of this CN is
vital to vision and visual fields and, in conjunction with CN III, pupillary reaction.
• CN III—Oculomotor: CN III, the eye (oculo-) movement (motor) nerve, works with
CNs III, IV, and VI (abducens, which helps the eyeball abduct or move). The actions
of these CNs are largely responsible for the movement of the eyeball and eyelid.
• CN IV—Trochlear: This nerve innervates the superior oblique muscle of the eye.
• CN V—Trigeminal: Three (tri) types of sensation (temperature, pain, and tactile)
come from this three- branched nerve that covers three territories of the face. For
normal
, corneal reflexes to be present, the afferent limb of the first division of CN V and the
effect limb of CN VII need to be intact.
• CN VI—Abducens
CN 7-12 - ANSWER • CN VII—Facial: Dysfunction of this nerve gives the
characteristic findings of Bell's palsy (facial asymmetry, droop of mouth, absent
nasolabial fold, impaired eyelid movement).
• CN VIII—Auditory or vestibulocochlear: When this nerve does not function properly,
hearing (auditory) or balance is impaired (vestibulocochlear). Rinne's test is part of
the evaluation of this CN.
• CN IX—Glossopharyngeal: The name of this CN pro- vides a clue that its function
affects the tongue (glosso) and throat (pharynx). Along with CN X, the function of this
nerve is critical to swallowing, palate elevation, and gustation.
• CN X—Vagus: This CN is involved in parasympathetic regulation of multiple organs,
including sensing aortic pressure and regulating blood pressure, slowing heart rate,
and regulating taste and digestive rate.
• CN XI—Accessory or spinal root of the accessory: Function of this CN can be tested
by evaluating shoulder shrug and lateral neck rotation.
• CN XII—Hypoglossal: Function of this CN is tested by noting movement and
protrusion of the tongue.
Which represents the most appropriate diagnostic test for the patient in the previous
question?
A. complete blood cell count with white blood cell
(WBC) differential
B. Lyme disease antibody titer
C. computed tomography (CT) scan of the head with contrast medium
D. blood urea nitrogen and creatinine levels - ANSWER B
lyme mimics
so does stroke, infxn, and tumors
In prescribing prednisone for a patient with Bell's palsy, the nurse practitioner (NP)
considers that its use:
A. has not been shown to be helpful in improving out-
comes in this condition.
B. should be initiated as soon as possible after the onset of
facial paralysis.
C. is likely to help minimize ocular symptoms. - ANSWER
B
Bells Palsy - ANSWER normally no other sx than the paralysis
Answers Verified 100% Correct
An 18-year-old man has no primary tetanus immuniza- tion series documented.
Which of the following repre- sents the immunization needed? A. three doses of
diphtheria, tetanus, and acellular pertussis (DTaP) vaccine 2 months apart
B. tetanus IG now and two doses of tetanus-diphtheria
(Td) vaccine 1 month apart
C. tetanus, diphtheria, and acellular pertussis (Tdap) vac- cine now with a dose of Td
vaccine in 1 and 6 months
D. Td vaccine as a single dose - ANSWER C
Which wound presents the greatest risk for tetanus infection?
A. a puncture wound obtained while gardening
B. a laceration obtained while trimming beef
C. a human bite
D. an abrasion obtained by falling on a sidewalk - ANSWER A
Tetanus is caused by - ANSWER Tetanus infection is caused by Clostridium tetani, an
anaerobic, gram-positive, spore-forming rod.
found in soil, especially manure.
enters through wound
tetanus sx - ANSWER systemic disease
painful muscle weakness
spasm (lockjaw)
10% mortality
most cases are adults over 50
Diptheria - ANSWER caused by Corynebacterium diphtheriae, a gram-negative
bacillus
typically transmitted from person- to-person contact via respiratory droplets or
cutaneous lesion.
This organism causes a severe illness involving the respiratory tract, including the
appearance of pseudomembranous pharyngitis and possible airway obstruction.
Owing to high immunization rates, a confirmed case of diphtheria has not been reported
,in the United States for more than a decade.
tetanus shot - ANSWER 3 dose
booster 10 years
if adult, need the 3 but 2 can be Td instead of Tdap
if minor wound and unclear vax hx give tet vax
if other wounds too give tet with immunoglob (TIG)
Usual treatment for an adult with acute hepatitis A includes:
A. interferon-alfa therapy.
B. high-dose ribavirin.
C. parenteral acyclovir.
D. supportive care. - ANSWER D
bad with coinfection of A and/or C can cause bad liver prob
Peak infectivity of persons with hepatitis A usually occurs:
A. before onset of jaundice.
B. at the time of maximum elevation of liver enzymes.
C. during the recovery period.
D. at the time of maximum disease-associated symptoms. - ANSWER A
peak HAV infectivity - ANSWER 2 wk period before onset of jaundice or elevation of
liver enzymes
when vax HAV before travel - ANSWER 4-6 wks if going to high rate country
how is polio transmitted - ANSWER fecal-oral
Vaccine associated paralytic poliomyeltitis - ANSWER when vax given orally, it is live,
a little comes out through stool and can be contagious. This is why oral is not done in
the US but is still used other places
Stages of change - ANSWER • Precontemplation: The patient is not interested in
change and might be unaware that the problem exists or minimizes the problem's
impact.
• Contemplation: The patient is considering change and looking at its positive and
negative aspects. The person often reports feeling "stuck" with the problem, unable to
figure out how to change to solve or minimize the health issue. • Preparation: The
,patient exhibits some change behaviors or thoughts and often reports feeling that he or
she does not have the tools to proceed.
• Action: The patient is ready to go forth with change, often takes concrete steps
to change, but is often inconsistent with carrying through.
• Maintenance/relapse: The patient learns to continue the change and has
adopted and embraced the healthy habit. Relapse can occur, however, and the person
learns to deal with backsliding.
You see a 48-year-old patient who started taking varenicline (Chantix) 4 weeks ago to
aid in smoking cessation. Which of the following is the most important question to ask
during today's visit?
A. "How many cigarettes a day are you currently smoking?"
B. "On a scale of 0 to 10, how strong is your desire to smoke?"
C. "Have you noticed any changes in your mood?"
D. "Are you having any trouble sleeping?"` - ANSWER C
Specifically, depressed mood, agitation, changes in behavior, suicidal ideation, and
suicide have been reported in patients attempting to quit smoking while using
varenicline. Patients should tell their healthcare provider about any history of
psychiatric illness before starting this medication; clinicians should also ask about
mental health history before starting this medication. Close monitoring for changes in
mood and behavior should follow.
You perform an extraocular movement test on a middle- aged patient. He is unable to
move his eyes upward and inward. This indicates a possibility of paralysis of CN:
A. II.
B. III.
C. V.
D. VI. - ANSWER B
Loss of corneal reflex is in part seen in dysfunction of CN:
A. III. B. IV. C. V. D. VI. - ANSWER C
CN 1-6 - ANSWER • CN I—Olfactory: You have one nose, where CN I resides. Its
function contributes to the sense of smell.
• CN II—Optic: You have two eyes, where you will find CN II. Function of this CN is
vital to vision and visual fields and, in conjunction with CN III, pupillary reaction.
• CN III—Oculomotor: CN III, the eye (oculo-) movement (motor) nerve, works with
CNs III, IV, and VI (abducens, which helps the eyeball abduct or move). The actions
of these CNs are largely responsible for the movement of the eyeball and eyelid.
• CN IV—Trochlear: This nerve innervates the superior oblique muscle of the eye.
• CN V—Trigeminal: Three (tri) types of sensation (temperature, pain, and tactile)
come from this three- branched nerve that covers three territories of the face. For
normal
, corneal reflexes to be present, the afferent limb of the first division of CN V and the
effect limb of CN VII need to be intact.
• CN VI—Abducens
CN 7-12 - ANSWER • CN VII—Facial: Dysfunction of this nerve gives the
characteristic findings of Bell's palsy (facial asymmetry, droop of mouth, absent
nasolabial fold, impaired eyelid movement).
• CN VIII—Auditory or vestibulocochlear: When this nerve does not function properly,
hearing (auditory) or balance is impaired (vestibulocochlear). Rinne's test is part of
the evaluation of this CN.
• CN IX—Glossopharyngeal: The name of this CN pro- vides a clue that its function
affects the tongue (glosso) and throat (pharynx). Along with CN X, the function of this
nerve is critical to swallowing, palate elevation, and gustation.
• CN X—Vagus: This CN is involved in parasympathetic regulation of multiple organs,
including sensing aortic pressure and regulating blood pressure, slowing heart rate,
and regulating taste and digestive rate.
• CN XI—Accessory or spinal root of the accessory: Function of this CN can be tested
by evaluating shoulder shrug and lateral neck rotation.
• CN XII—Hypoglossal: Function of this CN is tested by noting movement and
protrusion of the tongue.
Which represents the most appropriate diagnostic test for the patient in the previous
question?
A. complete blood cell count with white blood cell
(WBC) differential
B. Lyme disease antibody titer
C. computed tomography (CT) scan of the head with contrast medium
D. blood urea nitrogen and creatinine levels - ANSWER B
lyme mimics
so does stroke, infxn, and tumors
In prescribing prednisone for a patient with Bell's palsy, the nurse practitioner (NP)
considers that its use:
A. has not been shown to be helpful in improving out-
comes in this condition.
B. should be initiated as soon as possible after the onset of
facial paralysis.
C. is likely to help minimize ocular symptoms. - ANSWER
B
Bells Palsy - ANSWER normally no other sx than the paralysis
