ACTUAL QUESTIONS AND CORRECT
ANSWERS
When evaluating a 78-year-old man, the PMHNP notices the patient frequently leans in with
the right side of his head and frequently asks for things to be repeated. His daughter is very
worried that he has dementia or depression because he has also become increasingly isolated,
as well as increasingly irritable as he believes people are yelling at him out of frustration of
not being heard. The daughter is tearful, anxious, and frustrated. What should the PMHNP do
first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the daughter - CORRECT
ANSWERS✅✅Examine the patient's ear canals
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?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology - CORRECT ANSWERS✅✅Explore the reason for not having had a
physical in so long
In observing the appearance of the patient with depression and a history of systemic lupus
erythematosus, the PMHNP notices a lesion on the neck of the patient about the size of a
pencil eraser, flush with the skin, uniformly colored, with discrete borders, and consistent
texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
, Refer the patient to rheumatology
Refer the patient to dermatology - CORRECT ANSWERS✅✅Watch and wait
Which of the following best represent the physical exam maneuver known as Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg up to the chest. A positive
test occurs when pain prohibits elevation of the ipsilateral leg.
The examiner palpates in the right upper abdominal quadrant below the costal margin while
the patient breathes in. The test is positive if the examiner observes pain during inhalation.
Press and palpate deeply into the abdomen and release quickly observing for pain.
Ask the patient to bend at the knees while holding onto a rail, observe for a loss of balance. -
CORRECT ANSWERS✅✅The examiner palpates in the right upper abdominal quadrant
below the costal margin while the patient breathes in. The test is positive if the examiner
observes pain during inhalation.
Acute cholecystitis
What does the Murphy sign assess for - CORRECT ANSWERS✅✅Cholecystitis
A 26-year-old man has been on an antipsychotic. He requires further titration for control of
symptoms. Which of the following tests should be repeated?
EKG
Head CT scan
Liver function test
Urinalysis - CORRECT ANSWERS✅✅EKG
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?