CMN 574 EXAM WITH CORRECT
QUESTIONS AND ANSWERS 2025
A female patient, currently at 26 weeks gestation, has experienced a slow
rise of her blood pressure over the past 2 weeks. Her urine specimen is
negative for protein. She has reduced her sodium intake and has begun a
walking program. The patient's blood pressure today is 155/102, which is
consistent with her readings at home. Associated symptoms include a dull
headache. The nurse practitioner's best response is:
a. "Try yoga and meditation to decrease your blood pressure."
b. Start the patient on methyldopa 250 mg po twice daily.
c. "Monitor your blood pressure at home and call the office if you have
swelling or a pounding headache."
d. Start the patient on metoprolol 100mg po twice daily. - CORRECT-
ANSWERS*b. Start the patient on methyldopa 250 mg po twice daily.
Rationale: Methyldopa has the longest record of safety at a starting dosage
of 250 mg po bid or tid. Therapy with beta blockers or calcium channel
blockers is also acceptable. (Papadakis& McPhee, 2015. P. 801.) Metoprolol is
a Category C medication and 100 mg po bid is not the lowest possible
starting dose. The initiation of anti-hypertensive therapy in pregnant women
,is indicated if the sustained blood pressure is > 150/100 or if there is
evidence of end-organ damage (Papadakis &McPhee, 2015, p. 801)
Resistant hypertension may be caused by which of the following?
a. NSAIDs
b. Oral Contraceptives
c. Obesity
d. All of the above - CORRECT-ANSWERS*d. All of the above
Rationale: JNC 7 defines resistant hypertension as the inability to control
blood pressure in those patients who are compliant with the appropriate
three-drug regimen, including a diuretic. Causes of resistant hypertension
listed in table 11-11 include nonadherence, NSAIDs, oral contraceptives,
adrenal steroids, licorice, obesity, and excessive alcohol intake (Sutters,
2015, p.458-459).
Cholesterol medication that works by obstructing the absorption of
cholesterol by blocking the passage of cholesterol across the intestinal wall
through the inhibition of a cholesterol transporter is ?
a. Statins
b. Fibric Acid
c. Ezetimibe
,d. Bile Acid - CORRECT-ANSWERS*c. Ezetimibe (Zetia) [Cholesterol
absorption inhibitor]
Rationale: "Ezetimibe is the lipid lower drug that works by inhibiting the
intestinal absorption of biliary and dietary cholesterol by blocking passage
across the intestinal wall by inhibiting a cholesterol transporter. Statins block
the rate-limiting enzyme in the formation of cholesterol. Fibrates are
peroxisome proliferative-activated receptor-alpha agonists that results in
potent reductions of plasms triglycerides and increases in HDL. Bile acids
work by binding bile acid in the intestine" (Baron, 2015).
A 2 year girl arrives to your clinic with a history of a fever for 7 days, cervical
lymphadenopathy, edema and desquamation of extremities, bilateral, non-
exudative conjunctivitis, and polymorphous exanthema. You correctly
diagnose the girl with :
a. Rheumatic fever
b. Kawasaki disease
c. Lyme disease
d. Infective endocarditis - CORRECT-ANSWERS*b. Kawasaki disease
, Rationale: The diagnostic criteria for Kawasaki disease are fever that lasts for
greater than 5 days and at least 4 of the following other manifestations: (1)
cervical lymphadenopathy, usually unilateral and great than or equal to 1.5
cm in diameter, (2) extremity changes (redness and swelling of the hands
and feet with subsequent desquamation), (3) polymorphous exanthema, (4)
oral cavity or lip changes, (such as strawberry tongues, fissuring and
cracking, and inflammation of the oral mucosa), and (5) painless, bilateral,
non-exudative conjunctivitis. Rheumatic fever consists of 2 major criteria
such as carditis, erythema marginatum, Sydenham chorea, or polyarthritis,
or 1 major criteria and 1 minor criteria, such as polyarthalgia, fever, and
previous rheumatic heart disease or fever, plus evidence to support
streptococcal infection. Infective endocarditis often presents with weight
loss, malaise, and fever. (Darst, Collins, & Miyamoto, 2014, p. 628). Lyme
disease may develop after a tick bite, and is characterized by erythema
chronicum migrans (Ogle & Anderson, 2014, p. 1350).
The Moro Reflex:
a. Disappears by age 3 months.
b. Disappears by age 4 months.
c. Disappears by age 8 months.
d. Disappears by age 12 months - CORRECT-ANSWERS*a. Disappears by age
3 months.
Rationale: (pg 15) The Moro (startle) reflex - hold the infant supine while
supporting the head. Allow head to drop 1-2 cm suddenly. Arms will abduct
QUESTIONS AND ANSWERS 2025
A female patient, currently at 26 weeks gestation, has experienced a slow
rise of her blood pressure over the past 2 weeks. Her urine specimen is
negative for protein. She has reduced her sodium intake and has begun a
walking program. The patient's blood pressure today is 155/102, which is
consistent with her readings at home. Associated symptoms include a dull
headache. The nurse practitioner's best response is:
a. "Try yoga and meditation to decrease your blood pressure."
b. Start the patient on methyldopa 250 mg po twice daily.
c. "Monitor your blood pressure at home and call the office if you have
swelling or a pounding headache."
d. Start the patient on metoprolol 100mg po twice daily. - CORRECT-
ANSWERS*b. Start the patient on methyldopa 250 mg po twice daily.
Rationale: Methyldopa has the longest record of safety at a starting dosage
of 250 mg po bid or tid. Therapy with beta blockers or calcium channel
blockers is also acceptable. (Papadakis& McPhee, 2015. P. 801.) Metoprolol is
a Category C medication and 100 mg po bid is not the lowest possible
starting dose. The initiation of anti-hypertensive therapy in pregnant women
,is indicated if the sustained blood pressure is > 150/100 or if there is
evidence of end-organ damage (Papadakis &McPhee, 2015, p. 801)
Resistant hypertension may be caused by which of the following?
a. NSAIDs
b. Oral Contraceptives
c. Obesity
d. All of the above - CORRECT-ANSWERS*d. All of the above
Rationale: JNC 7 defines resistant hypertension as the inability to control
blood pressure in those patients who are compliant with the appropriate
three-drug regimen, including a diuretic. Causes of resistant hypertension
listed in table 11-11 include nonadherence, NSAIDs, oral contraceptives,
adrenal steroids, licorice, obesity, and excessive alcohol intake (Sutters,
2015, p.458-459).
Cholesterol medication that works by obstructing the absorption of
cholesterol by blocking the passage of cholesterol across the intestinal wall
through the inhibition of a cholesterol transporter is ?
a. Statins
b. Fibric Acid
c. Ezetimibe
,d. Bile Acid - CORRECT-ANSWERS*c. Ezetimibe (Zetia) [Cholesterol
absorption inhibitor]
Rationale: "Ezetimibe is the lipid lower drug that works by inhibiting the
intestinal absorption of biliary and dietary cholesterol by blocking passage
across the intestinal wall by inhibiting a cholesterol transporter. Statins block
the rate-limiting enzyme in the formation of cholesterol. Fibrates are
peroxisome proliferative-activated receptor-alpha agonists that results in
potent reductions of plasms triglycerides and increases in HDL. Bile acids
work by binding bile acid in the intestine" (Baron, 2015).
A 2 year girl arrives to your clinic with a history of a fever for 7 days, cervical
lymphadenopathy, edema and desquamation of extremities, bilateral, non-
exudative conjunctivitis, and polymorphous exanthema. You correctly
diagnose the girl with :
a. Rheumatic fever
b. Kawasaki disease
c. Lyme disease
d. Infective endocarditis - CORRECT-ANSWERS*b. Kawasaki disease
, Rationale: The diagnostic criteria for Kawasaki disease are fever that lasts for
greater than 5 days and at least 4 of the following other manifestations: (1)
cervical lymphadenopathy, usually unilateral and great than or equal to 1.5
cm in diameter, (2) extremity changes (redness and swelling of the hands
and feet with subsequent desquamation), (3) polymorphous exanthema, (4)
oral cavity or lip changes, (such as strawberry tongues, fissuring and
cracking, and inflammation of the oral mucosa), and (5) painless, bilateral,
non-exudative conjunctivitis. Rheumatic fever consists of 2 major criteria
such as carditis, erythema marginatum, Sydenham chorea, or polyarthritis,
or 1 major criteria and 1 minor criteria, such as polyarthalgia, fever, and
previous rheumatic heart disease or fever, plus evidence to support
streptococcal infection. Infective endocarditis often presents with weight
loss, malaise, and fever. (Darst, Collins, & Miyamoto, 2014, p. 628). Lyme
disease may develop after a tick bite, and is characterized by erythema
chronicum migrans (Ogle & Anderson, 2014, p. 1350).
The Moro Reflex:
a. Disappears by age 3 months.
b. Disappears by age 4 months.
c. Disappears by age 8 months.
d. Disappears by age 12 months - CORRECT-ANSWERS*a. Disappears by age
3 months.
Rationale: (pg 15) The Moro (startle) reflex - hold the infant supine while
supporting the head. Allow head to drop 1-2 cm suddenly. Arms will abduct
