Page 1 of 72
NR601 MIDTERM
STUDY GUIDE PRACTICE EXAM QUESTIONS
WITH ANSWERS TESTED AND MODIFIED
Mr. Gonzalez a 65-year-old patient with type 2 diabetes reported to the primary care office
with complaints of weakness, fatigue, and diaphoresis. A review of the patient's blood sugars
over the last seven days demonstrates 2 sugars of 58 mg/DL and 56 MG/ DL respectively
period to narrow the differential diagnosis what should the NP do first?
-- ANSWER--Determine if the hypoglycemia is related to alcohol
Clinical findings in a patient with hypothyroidism includes:
-- ANSWER--facial and eyelid edema
There are well described racial and socioeconomic disparities in diagnosis, the following
populations have the higher incidence and lower survival
-- ANSWER--black and hispanic older adults in general
A 72 yo female has residual effects from a stroke that includes memory loss and apathy.
Which intervention can best improve the brain's functional reserve?
-- ANSWER--decrease overstimulating the patient to avoid agitation
,Page 2 of 72
The NP is providing chronic management for a 74-year-old male with longstanding COPD.
He presents to the primary care office with increased shortness of breath to the point that he
is unable to walk to the mailbox or send a flight of stairs in his home. He reports that he still
smokes 1/4 pack of cigarettes per day. He tells the NP I guess I'm just getting too old to do
normal things anymore. The NP recognizes that the decline in the patient's physical function
is due to:
-- ANSWER--disease-related disability
The physiologic eye changes that occur in adults between the ages of 42 to 50 years of age
that indicate the new reading glasses are due to
-- ANSWER--reduced lens elasticity
A 64-year-old homeless female reports to the primary care clinic with shortness of breath.
Approximately one week the patient presented to the emergency room with mild sternal chest
pain. A cardiac workup revealed no abnormalities And the patient was released. Today the
patient reports that her breathlessness is worse. The pmh includes hypertension,
hyperlipidemia, atherosclerotic heart disease. The patient is also pack year smoker. Other
than seeking medical care at the ER last week the patient has not seen a health care provider
in five years period based on the patient's age and condition what immunizations are most
important for the MP to administer today?
-- ANSWER--Influenza, Prevnar-13
,Page 3 of 72
A 65 year old male patient is a 36 pack year smoker who is seeing the MP today for smoking
cessation intervention. The MPP plans to use the 5 A's in planning interventions for this
patient. In addition to prescribing a nicotine patch the patient has also agreed to participate in
intensive cessation counseling covered by Medicare. When the NP scheduled future follow
up visit for the patient which 5A is being utilized?
-- ANSWER--Arrange
The NP has diagnosed a 62-year-old female with Graves' disease. What lab value below was
used to diagnose?
-- ANSWER--Decreased TSH level
The NP is reviewing a 68-year-old males 2 fasting plasma glucose levels completed on
separate occasions. Diagnosing type 2 diabetes both plasma glucose levels must be greater
than
-- ANSWER--126 mg/dL
An older adult with type 2 diabetes presents to the primary care clinic with a report of
polyurea, polydipsia, and loss. Which of the following lab results requires immediate
intervention by the NP?
-- ANSWER--Serum glucose of 65 mg/dL
, Page 4 of 72
60-year-old male reports to the primary care office with a complaint of feeling down since the
death of his spouse eight months ago. He has suppressed his depression through the use of
alcohol. His medical history includes gerd, atrial fibrillation, and chronic back pain. His
medications include:
Cyclobenzaprine 10 milligrams as needed for pain, warfarin 5 milligrams daily, pantoprazole
40 milligrams daily, lisinopril 10 milligrams daily, Flomax 0.4 milligrams daily, multivitamin
daily, vitamin C 500 milligrams daily, and vitamin D 1000 IU daily. The MP decides to
perform the cage assessment to determine the patient's extent of alcohol dependency and
obtains a score of three which signifies alcohol use disorder. The NP also performs a
medication review and identifies that some of his medications metabolic effects are altered by
alcohol. Which of the medications should be of concern for the NP?
-- ANSWER--Cyclobenzaprine (Amrix), Warfarin, and Pantoprazole (Protonix)
A 68-year-old female presents to the primary care office as a new patient who recently
located from Florida. The patient reports a past medical history of vitamin B12 deficiency,
hypertension, hyperlipidemia, and gerd. The patient reports that one year ago she was seen by
gastroenterologist for gerd symptoms where she was prescribed omeprazole 40 milligrams
daily. She reports that after being on the omeprazole for two months she stopped having
guard symptoms. Therefore an endoscopy was not indicated. Despite having no symptoms
she continued to take omeprazole because she did not want her symptoms to return. She also
reports that diet modification has also helped him reduce and gerd symptoms. The MP
determines that omeprazole should be prescribed. The best prescribing method for this patient
is
-- ANSWER--Reducing the omeprazole from 40 mg to 20 mg
NR601 MIDTERM
STUDY GUIDE PRACTICE EXAM QUESTIONS
WITH ANSWERS TESTED AND MODIFIED
Mr. Gonzalez a 65-year-old patient with type 2 diabetes reported to the primary care office
with complaints of weakness, fatigue, and diaphoresis. A review of the patient's blood sugars
over the last seven days demonstrates 2 sugars of 58 mg/DL and 56 MG/ DL respectively
period to narrow the differential diagnosis what should the NP do first?
-- ANSWER--Determine if the hypoglycemia is related to alcohol
Clinical findings in a patient with hypothyroidism includes:
-- ANSWER--facial and eyelid edema
There are well described racial and socioeconomic disparities in diagnosis, the following
populations have the higher incidence and lower survival
-- ANSWER--black and hispanic older adults in general
A 72 yo female has residual effects from a stroke that includes memory loss and apathy.
Which intervention can best improve the brain's functional reserve?
-- ANSWER--decrease overstimulating the patient to avoid agitation
,Page 2 of 72
The NP is providing chronic management for a 74-year-old male with longstanding COPD.
He presents to the primary care office with increased shortness of breath to the point that he
is unable to walk to the mailbox or send a flight of stairs in his home. He reports that he still
smokes 1/4 pack of cigarettes per day. He tells the NP I guess I'm just getting too old to do
normal things anymore. The NP recognizes that the decline in the patient's physical function
is due to:
-- ANSWER--disease-related disability
The physiologic eye changes that occur in adults between the ages of 42 to 50 years of age
that indicate the new reading glasses are due to
-- ANSWER--reduced lens elasticity
A 64-year-old homeless female reports to the primary care clinic with shortness of breath.
Approximately one week the patient presented to the emergency room with mild sternal chest
pain. A cardiac workup revealed no abnormalities And the patient was released. Today the
patient reports that her breathlessness is worse. The pmh includes hypertension,
hyperlipidemia, atherosclerotic heart disease. The patient is also pack year smoker. Other
than seeking medical care at the ER last week the patient has not seen a health care provider
in five years period based on the patient's age and condition what immunizations are most
important for the MP to administer today?
-- ANSWER--Influenza, Prevnar-13
,Page 3 of 72
A 65 year old male patient is a 36 pack year smoker who is seeing the MP today for smoking
cessation intervention. The MPP plans to use the 5 A's in planning interventions for this
patient. In addition to prescribing a nicotine patch the patient has also agreed to participate in
intensive cessation counseling covered by Medicare. When the NP scheduled future follow
up visit for the patient which 5A is being utilized?
-- ANSWER--Arrange
The NP has diagnosed a 62-year-old female with Graves' disease. What lab value below was
used to diagnose?
-- ANSWER--Decreased TSH level
The NP is reviewing a 68-year-old males 2 fasting plasma glucose levels completed on
separate occasions. Diagnosing type 2 diabetes both plasma glucose levels must be greater
than
-- ANSWER--126 mg/dL
An older adult with type 2 diabetes presents to the primary care clinic with a report of
polyurea, polydipsia, and loss. Which of the following lab results requires immediate
intervention by the NP?
-- ANSWER--Serum glucose of 65 mg/dL
, Page 4 of 72
60-year-old male reports to the primary care office with a complaint of feeling down since the
death of his spouse eight months ago. He has suppressed his depression through the use of
alcohol. His medical history includes gerd, atrial fibrillation, and chronic back pain. His
medications include:
Cyclobenzaprine 10 milligrams as needed for pain, warfarin 5 milligrams daily, pantoprazole
40 milligrams daily, lisinopril 10 milligrams daily, Flomax 0.4 milligrams daily, multivitamin
daily, vitamin C 500 milligrams daily, and vitamin D 1000 IU daily. The MP decides to
perform the cage assessment to determine the patient's extent of alcohol dependency and
obtains a score of three which signifies alcohol use disorder. The NP also performs a
medication review and identifies that some of his medications metabolic effects are altered by
alcohol. Which of the medications should be of concern for the NP?
-- ANSWER--Cyclobenzaprine (Amrix), Warfarin, and Pantoprazole (Protonix)
A 68-year-old female presents to the primary care office as a new patient who recently
located from Florida. The patient reports a past medical history of vitamin B12 deficiency,
hypertension, hyperlipidemia, and gerd. The patient reports that one year ago she was seen by
gastroenterologist for gerd symptoms where she was prescribed omeprazole 40 milligrams
daily. She reports that after being on the omeprazole for two months she stopped having
guard symptoms. Therefore an endoscopy was not indicated. Despite having no symptoms
she continued to take omeprazole because she did not want her symptoms to return. She also
reports that diet modification has also helped him reduce and gerd symptoms. The MP
determines that omeprazole should be prescribed. The best prescribing method for this patient
is
-- ANSWER--Reducing the omeprazole from 40 mg to 20 mg
