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A 52-year-old obese man with type 2 diabetes reports dozing off while driving, watching TV, or
reading, with increased apathy and fatigue. The PMHNP ordered a sleep study, which revealed 10
episodes of apnea lasting 15 to 20 seconds each per hour of sleep. Based on these findings, what
should the PMHNP prescribe for his condition?
-Referral to otolaryngology for rhinoplasty
-Antidepressant medications
-Referral to otolaryngology for uvuloplasty
-Continuous positive airway pressure ✔Correct answer-Continuous positive airway pressure
Which of the following is an indication for monitoring of serum drug levels?
-Smoking cessation
-New diagnosis of hyperlipidemia
-Resolution of symptoms
-New diagnosis of diabetes ✔Correct answer-Smoking cessation
Your client Jamie asks you about a mole of her forearm. You refer her to dermatology. As an APRN,
you recognize that cancerous moles can be detected on exam. Which of the following would not be
of concern?
-A mole that is not elevated
-All of the above
-A dark mole
-A mole that is 5 mm in size ✔Correct answer-All of the above
Recall the ABCDE acronym. Concerning moles are asymmetric, have irregular borders, have color
variation, a diameter > 6mm and elevated moles.
A 42-year-old female recalls a brief episode of chest tightness with no radiation or chest wall injury
during her new taekwondo martial arts class. This pain subsided during "the cool down period" of
her class. Which of the following is most likely given her presentation?
-Pericarditis
-Acute myocardial infarction
-Hiatal hernia
-Angina pectoris ✔Correct answer-Angina pectoris
Chest pain with activity and relieved at rest in a middle-aged adult should prompt concern for
myocardial ischemia. Although acute myocardial infarction is a possibility, it is less likely given the
scenario mentioned above.
Gloria is a 68-year-old female with a chronic history of severe anxiety disorder presents with mild
shortness of breath, fine crackles in the right lower lobe with auscultation and a nonproductive
,cough. She recently "ran out of pills". Which medication omission most likely lead to her current
presenting symptoms?
-Metoprolol
-Lorazepam
-Furosemide
-Metformin ✔Correct answer-Furosemide
Furosemide or Lasix is a diuretic utilized in the management of heart failure. Although anxiety can
produce shortness of breath, one would not expect fine crackles on exam unless additional
comorbidity exists.
The S2 heart sound is a result of what?
-Closure of the semilunar valves
-Opening of the semilunar valves
-Closure of the atrioventricular valves
-Opening of the atrioventricular valves ✔Correct answer-Closure of the semilunar valves
The closure of the semilunar valves results in the second heart sound. The semilunar valves are the
aortic and pulmonary valves.
A systematic inquiry that elaborates on the chief complaint while eliciting pertinent positive and
pertinent negative factors from the history is known as:
-Diagnostic formulation
-The mental status exam
-Physical exam
-Review of systems ✔Correct answer-Review of systems
A 21-year-old man had his first drink at his birthday party with friends last night. He presented the
following morning to the emergency department with psychomotor agitation, cognitive impairment,
depressed mood, flat affect, and anhedonia. His heart rate is 110, his blood pressure is 90/60, and he
complains of abdominal pain. He received 2 L of normal saline IV and is referred to psychiatry for
evaluation of mood disorder. Which of the following tests should the consulting PMHNP order given
these symptoms?
-Urinalysis
-Acetaminophen level
-Urinary porphobilinogen
-Blood alcohol level ✔Correct answer-Urinary porphobilinogen
A 35-year-old man diagnosed with bipolar disorder mentions to his PMHNP that he had felt a lump
on his left testicle. He is concerned he has not had a physical exam in 10 years. What is the best
action by the PMHNP?
-Perform a urogenital exam and order an ultrasound
-Refer him to his primary care provider
-Refer him to urology
-Explore the reason for not having had a physical in so long ✔Correct answer-Explore the reason
for not having had a physical in so long
, An 81-year-old female is found in acute respiratory distress after chocking on a hotdog during lunch.
On exam, which of the following lungs sounds are you most likely to hear?
-Bronchophony
-Egophony
-Crackles
-Stridor ✔Correct answer-Stridor
Stridor is the result of an upper airway obstruction, such as when there is a sudden acute aspiration
of an object.
A PMHNP employed within a small telehealth practice routinely "curb side consults" a collaborative
psychiatrist within the same state through email. The email includes the client's name in the subject
line and the email body includes a general question about Risperdal management. Is this considered
a HIPAA violation?
-No, the collaborative psychiatrist is located in the same practicing state as the PMHNP.
-Yes, the email mentions Clozaril and medications cannot be discussed via email.
-Yes, this became a HIPAA violation when she put the client's name in the title subject line.
-No, the body of the email does not include protected psychotherapy notes. ✔Correct answer-Yes,
this became a HIPAA violation when she put the client's name in the title subject line.
HIPAA privacy laws include telehealth and email technologies. The client's name should not be in the
subject line. Email sent outside of an organization must be encrypted. In this case, the email is within
the same organization
Unless the patient provides consent for releasing information, the Health Information Portability and
Accountability Act (HIPAA) prohibits the disclosure of personal health identifiers to all of the
following except:
-The patient's clergy
-The patient's attorney
-The patient's next of kin
-The patient's health insurance company ✔Correct answer-The patient's health insurance company
What method of analysis describes the basic features of the data and summarizes and organizes
observations?
-Inferential statistics
-Regression analysis
-Analysis of variance (ANOVA)
-Descriptive statitistics ✔Correct answer-Descriptive statitistics
The Nurse Practice Act and scope of practice are regulated by whom?
-Joint Commission
-American Nurses Association
-Commission on Nursing education
-Board of Nursing ✔Correct answer-Board of Nursing