FNP NR 511 MIDTERM EXAM STUDY GUIDE 2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION

FNP NR 511 MIDTERM EXAM STUDY GUIDE 2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES || 100% GUARANTEED PASS RECENT VERSION 1. S+S of Viral Conjunctivitis - ANSWER With/or without cold symptoms itchy, red eyes possible discharge **Preauricular lymph node swelling/tenderness** **Skin vesicles and corneal infection with dendrite appearance- HSV-1 & HSV-2** 2. Education for Viral Conjunctivitis - ANSWER How to use eye drops Throw away infected makeup Throw away infected contact lenses Don't use contacts while having active infection 3. S+S for Bacterial Conjunctivitis - ANSWER Red eye Crusty eye lid Normal visual acuity Watery itchy eyes Photophobia 4. Education for Bacterial Conjuncitivis - ANSWER Very contagious- dont go to work/school for 24h post antibiotic start. 5. Treatment for Viral Conjunctivitis - ANSWER Systemic antivirals- Acyclovir 6. S+S of Cataracts - ANSWER Gradual vision loss Painless **Age related- bilateral with blurred vision at night** No evidence that vitamin E and C or Beta-carotene help 7. What causes Blepharitis - ANSWER inflammation of the eyelid Staph Dysfunctional Meioban glands 8. Important details regarding Acute Angle-Closure Glaucoma - ANSWER This is an EMERGENCY---can cause blindness If a sudden IOP there can be permanent damage to optic nerve 9. What is the treatment for barotrauma to the ear canal with high middle ear pressure? - ANSWER Nasal steroids and decongestants 10. What is the difference between sensorineural and conductive hearing loss? - ANSWER S: Sound can get in, just not process appropriately; caused by loud noise, ear infections, or aging C: Sound can't get to inner ear; Too much ear wax, otitis media 11. Testing for hearing loss - ANSWER Weber: Tuning fork on head If louder in bad ear=conductive hearing loss If louder in good ear=sensorineural hearing loss 12. Must know for Hearing Loss - ANSWER Any pt with sudden sensorineural hearing loss needs an IMMEDIATE referral to otorhinolaryngologist 13. What is tinnitus? - ANSWER Ringing in the ears 14. Tests for Tinnitus - ANSWER Tympanometry 15. Acoustic Reflux 16. Tx for Tinnutus - ANSWER The goal is to minimize sound by... playing background noise stop smoking decrease caffeine sleep hygiene 17. Must knows for tinnitus - ANSWER If the ringing is high pitched=HTN Severe tinnitus may be a neurodepressive disorder and should have a depression eval. 18. S+S for Mononucleosis - ANSWER Fatigue Sore throat Low grade fever Nasal/throat erythema Swollen tonsils with exudates **Enlarged cervical lymph nodes 19. What is the test for Mono? - ANSWER Monospot 20. S+S for Epiglottitis - ANSWER Severe throat pain Difficulty swallowing Increased secretions Stridor Resp difficulty Fever **There WON'T be pharyngeal erythema or cough** 21. What are signs of respiratory distress in a pediatric patient - ANSWER Stridor Restlessness Nasal flaring Accessory muscle use 22. S+S of Pharyngitis - ANSWER Discomfort Scratchy throat Difficulty swallowing 23. Tx for Pharyngitis - ANSWER PCN if strep + 24. S+S of Hoarseness - ANSWER Change in pitch 25. Test for Hoarseness - ANSWER Laryngoscopy 26. What causes hoarsness - ANSWER overuse viruses growths infection-papillomatosis** 27. Where does a peritonsillar abscess usually form? - ANSWER Between tonsils and superior pharyngeal constrictor muscle Usually unilateral 28. S+S of Peritonsillar abscess - ANSWER Sore throat Fever Asymmetrical cervical lymph nodes They will sounds like they have "lock jaw" voice Toxic appearance **Most likely in teens** 29. Tx for Peritonsillar abscess - ANSWER Refer to ER 30. S+S of Rhinitis - ANSWER Sneezing Runny nose Watery eyes 31. Tx for Rhinitis - ANSWER Avoid triggers 32. What could occur when using decongestants for viral rhinitis? - ANSWER Rebound symptoms 33. What the the atopic triad? - ANSWER Genetic Patient will have a family hx of 1. Asthma 2. Allergic rhinitis 3. Eczema 34. What does the mnemonic OLDCARTS stand for? - ANSWER Onset Location Duration Character Aggravating factors Relieving Factors Timing Severity 35. Specificity vs. Sensitivity - ANSWER Specificity: If its high--ability to show normal results in patients without disease If its low--gives false positives Sensitivity: Ability to show true positives 36. What determines clinical decision making? - ANSWER EBP Clinical Practice Guidelines EB Algorithms 37. Traditional Medicare - ANSWER Part A: covers in patient stays Part B: Covers out patient stays Part C: Wellness visit coverage Part D: Prescriptions 38. How do Medicare patients typically cover out of pocket expenses? - ANSWER They get secondary insurance 39. How much are NP's reimbursed? - ANSWER 85% of MD fee 40. What are the benefits of a Medicare Advantage Plan - ANSWER Same traditional benefits as Medicare Lower co pay **Carriers(those who sell it) are subsidized per member by CMS Provides CMS services at a lower cost 41. What are the seven 3rd party payers for insurance? - ANSWER Medicare Medicaid Indemnity Insurance Managed Care Workers Comp Veteran's Admin Auto liability 42. S+S for a Fungal Skin Infection - ANSWER Papular rash Satellite lesions Well defined border 43. Tx for Fungal Infection - ANSWER Antifungal cream Keep it dry 44. Who is at risk for developing a fungal infection? - ANSWER Immunocompromised Elderly Infants Diabetics Antibiotic use AIDS Steroids Transplant patients Chemotherapy PICC line 45. Define diagnostic reasoning - ANSWER Reflective thinking because the process involves questioning one's thinking to determine if all possible avenues have been explored and if the conclusions that are being drawn are based on evidence. Seen as a kind of critical thinking. 46. What is subjective data? - ANSWER Anything the patient tells you or complains of regarding their symptoms Chief complaint HPI ROS 47. What is objective data? - ANSWER Anything YOU can see, touch, feel, hear, or smell as part of your exam Includes lab data, diagnostic test results, etc. 48. Identify components of HPI - ANSWER Specifically related to the chief complaint only Detailed breakdown of CC OLDCARTS 49. Describe the differences between medical billing and medical coding. - ANSWER Medical billing: process of submitting and following up on claims made to a payer in order to receive payment for medical services rendered by a healthcare provider Medical coding: the use of codes to communicate with payers about which procedures were performed and why. 50. Compare and contrast the two coding classification systems that are currently used in the US healthcare system. - ANSWER ICD: International classification of disease codes are used to provide payer info on necessity of visit or procedure performed. Shorthand for pt's dx. CPT: common procedural terminology codes offer the official procedural coding rules and guidelines required when reporting medical services and procedures performed by physician and non-physician providers. Must have corresponding ICD. 51. How do specificity, sensitivity, and predictive value contribute to the usefulness of diagnostic data? - ANSWER Specificity: ability of a test to correctly detect a specific condition. If a pt has a condition but test is negative, it is a false negative. If pt does NOT have condition but test is positive, it is false positive. Sensitivity: test that has few false negatives. Ability of a test to correctly identify a specific condition when it is present. The higher the sensitivity, the lesser the likelihood of a false negative. Predictive value: The likelihood that the pt actually has the condition and is, in part, dependent upon the prevalence of the condition in the population. If a condition is highly likely, the positive result would be more accurate. Diagnostic tests can be used to confirm or rule out hypotheses. Diagnostic tests may be used to screen for conditions. Diagnostic tests may be used to monitor the progress in managing a chronic condition. 52. Discuss the elements that need to be considered when developing a plan. - ANSWER Pt's preferences and actions Research evidence Clinical state/circumstances Clinical expertise 53. Describe the components of medical decision making in E&M coding. - ANSWER Risk, data, diagnosis The more time and consideration involved in dealing with a pt, the higher the reimbursement from the payer. Documentation must reflect MDM 54. Correctly order the E&M office visit codes based on complexity from least to most complex. - ANSWER New pt: 1. Minimal/RN visit: 99201 2. Problem focused: 99202 3. Expanded problem focused: 99203 4. Detailed: 99204 5. Comprehensive: 99205 Established pt: 1. Minimal/RN visit: 99211 2. Problem focused: 99212 3. Expanded problem focused: 99213 4. Detailed: 99214 5. Comprehensive: 99215 55. The 5 key components of a comprehensive treatment plan are: - ANSWER 1. Diagnostics 2. Medication 4. Education 5. Referral/consultation 6. Follow-up planning 56. Define the components of a SOAP note. - ANSWER S: subjective (what the pt tells you) CC HPI PMH Fam Hx Social Hx ROS 57. O: objective (what you can see, hear, feel on exam) Physical findings Vital signs General survey HEENT Etc... A: assessment Global assessment of pt including differentials in order from most to least likely Combination of subjective and objective info List of dx addressed and billed for at the visit P: plan What you will Rx When to come back Diagnostic tests Pt education 58. Discuss minimum of three purposes of the written history and physical in relation to the importance of documentation. - ANSWER Important reference document that gives concise info about the pt's hx and exam findings 59. Outlines a plan for addressing issues that prompted the visit. Info should be presented in a logical fashion that prominently features all data relevant to the pt's condition. Is a means of communicating info to all providers involved in pt's care Is a medical-legal document Is essential in order to accurately code and bill for services Why does every procedure code need a corresponding diagnosis code? - ANSWER Diagnosis code explains the necessity of the procedure code. Insurance won't pay if they don't correspond. 60. What are the three components required in determining an outpatient, office visit E&M code? - ANSWER Plan of service Type of service Patient status 61. Correctly ID a pt as a new or established given historical info. - ANSWER Pt status: whether or not pt is new or established. New: has not received professional service from provider in same group within past 3 years. Established: has received professional service from provider in same group in last 3 years. 62. What does a well-rounded clinical experience mean? - ANSWER Includes seeing kids from birth through young adult visits for well child and acute visits, as well as adults for wellness or acute/routine visits. 63. Seeing a variety of pt's, including 15% of peds and 15% of women's health of total time in the program. 64. What are the maximum number of hours that time can be spent "rounding" in a facility? - ANSWER No more than 25% of total practicum hours in the program 65. What are 9 things that must be documented when inputting data into clinical encounter logs? - ANSWER Date of service Age Gender and ethnicity Visit E&M code CC Procedures Tests performed/ordered Dx Level of involvement 66. What does the acronym SNAPPS stand for? - ANSWER S: summarize (present pt's H&P findings) N: narrow (based on H&P, narrow down top 2-3 differentials) A: analyze (compare/contrast H&P findings for each differential and narrow it down to most likely one) P: probe (ask preceptor questions of anything you are unsure of) P: plan (come up with specific management plan) S: Self-directed learning (opportunity to investigate more about topics you are uncertain of) 67. What is the most common type of pathogen responsible for acute gastroenteritis? - ANSWER Viral (can be viral, bacterial, or parasitic), usually norovirus 68. All of the following medications are used for the control of nausea and vomiting. Which medication works by affecting the chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal sphincter pressure? 1.Anticholinergics, such as scopolamine (Donnatal). 2.Antidopaminergic agents, such as prochlorperazine (Compazine). 3.Antidopaminergic and cholinergic agents, such as metoclopramide (Reglan). 4.Tetrahydrocannabinols, such as dronabinol (Marinol) - ANSWER Antidopaminergic and cholinergic agents, such as metoclopramide (Reglan) rationale: Metoclopramide (Reglan) is used for diabetic gastroparesis and postoperative nausea and vomiting. It works by affecting the chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal sphincter pressure 69. You auscultate Julie's abdomen and hear a peritoneal friction rub. Which condition do you rule out? 1.Peritonitis. 2.A liver or spleen abscess. 3.A liver or spleen metastatic tumor. 4.Irritable bowel syndrome. - ANSWER IBS rationale: IBS does not produce a friction rub 70. You are counseling Lillian, who is lactose intolerant, about foods to avoid. You know she misunderstands the teaching when she tells you she can have: 1. Yogurt. 2.Foods containing whey. 3.Prehydrolyzed milk. 4.Oranges. - ANSWER Foods containing whey rationale: Advise clients who are lactose intolerant to avoid foods containing whey. Whey is a lactose-rich ingredient found in some foods, so clients who are lactose intolerant need to read labels on all foods. To control symptoms, dietary lactose should be reduced or restricted by using lactose-reduced and lactose-free dairy products or by eating lactose-rich foods in small amounts or in combination with low-lactose or lactose-free foods. 71. Simon, age 72, states that he is worried because he has a bowel movement only every third day. You respond: 1."You should have two to three stools per day." 2."You should defecate once a day." 3."You should have at least three stools per week." 4."There is no such thing as a 'normal' pattern of defecation." - ANSWER There is no such thing as a normal pattern of defecation rationale: There is no such thing as a "normal" pattern of defecation. Patterns of defecation vary widely and may in part be affected by dietary habits, fluid intake, bacteria in the stool, psychological stress, or voluntary postponement of defecation. Defecating every third day could be the routine pattern for Simon. He should be questioned if this is routine for him. 72. Timothy, age 68, complains of an abrupt change in his defecation pattern. You evaluate him for: 1.Constipation. 2.Colorectal cancer. 3.Irritable bowel syndrome. 4.Acute appendicitis. - ANSWER Colorectal cancer rationale: A middle-aged or older client with an abrupt change in defecation pattern must be evaluated for colorectal cancer 73. Rose has gastroesophageal reflux disease (GERD). You know she misunderstands your teaching when she tells you she will: 1.Avoid coffee, alcohol, chocolate, peppermint, and spicy foods. 2.Eat smaller meals. 3.Have a snack before retiring so that the esophagus and stomach are not empty at bedtime. 4.Stop smoking. - ANSWER Have a snack before retiring so that the esophagus and stomach are not empty at bedtime. rationale: Rose should not have a snack before retiring. Clients with GERD should be instructed to avoid coffee, alcohol, chocolate, peppermint, and spicy foods; eat smaller meals; stop smoking; remain upright for 2 hours after meals; elevate the head of the bed on 6- to 8-in blocks; and refrain from eating for 3 hours before retiring. 74. You suspect appendicitis in Andrew, who is 18. With his right hip and knee flexed, you slowly rotate his right leg internally to stretch a muscle. He states that it is painful over his right lower quadrant. Which sign did you elicit? 1.Rovsing sign. 2.Psoas sign. 3.Obturator sign. 4.McBurney sign - ANSWER Obturator sign. rationale: Obturator sign is elicited when, with the patient's right hip and knee flexed, the examiner slowly rotates the right leg internally,