Docsity
Log inSign up
Docsity
Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity

Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan

Guidelines and tips
Guidelines and tips
Sell on Docsity
Sell on Docsity
Log inSign up

Prepare for your exams

Study with the several resources on Docsity

Find documents

Prepare for your exams with the study notes shared by other students like you on Docsity

Search Store documents

The best documents sold by students who completed their studies

Search through all study resources
Docsity AINEW

Summarize your documents, ask them questions, convert them into quizzes and concept maps

Explore questions

Clear up your doubts by reading the answers to questions asked by your fellow students

Earn points to download

Earn points by helping other students or get them with a premium plan

Share documents
download point icon20 Points

For each uploaded document

Answer questions
download point icon5 Points

For each given answer (max 1 per day)

All the ways to get free points
Get points immediately

Choose a premium plan with all the points you need

Study Opportunities

Choose your next study program

Get in touch with the best universities in the world. Search through thousands of universities and official partners

Community

Ask the community

Ask the community for help and clear up your study doubts

University Rankings

Discover the best universities in your country according to Docsity users

Free resources

Our save-the-student-ebooks!

Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors

From our blog

Exams and Study
Go to the blog

NR577 Exam verified questions and correct answer 2025-2026, Exams of Nursing

Watts School of NursingNursing

NR577 Exam verified questions and correct answer 2025-2026NR577 Exam verified questions and correct answer 2025-2026

Typology: Exams

2024/2025

Available from 07/01/2025

Maggieobita
Maggieobita 🇺🇸

3.7

(20)

1.2K documents

1 / 88

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
NR577 Examverified questions and correct answer 2025-2026
1. A 56-year-old patient comes in for a routine well visit. He has a history of a previous
stroke and Type 2 Diabetes. Which of the following orders would be appropriate for a
patient with a previous stroke?
A. Initiate statin therapy
B. EEG
C. Warfarin therapy with an INR goal of 2-3
D. MRI - correct answerA.
Patients with a history of an ASCVD should be started on statin therapy regardless of
current LDL. The question did not mention any other symptoms that would warrant
additional diagnostics. Warfarin therapy is only indicated if AFIB would be the primary
indication for anticoagulation after a stroke.
2. A 36-year-old female is being seen in your clinic for left sided facial weakness. In
your review of systems, the patient reports that "certain sounds really bother me and my
taste buds seem off". She also reports temporal pain which has subsided. Your physical
exam reveals no other neurological deficits. Which of the following interventions would
be most appropriate?
A. Call 911 to activate emergency stroke protocols
B. Refer the patient to neurology
C. Order an MRI
D. Prescribe a course of oral corticosteroids - correct answerD.
Bell's Palsy commonly causes alterations in taste and hyperacusis. This contrasts with
stroke. Corticosteroids increase the chances of recovery complete by 12-15% at nine to
twelve months and are routinely prescribed. The complaint of pain also suggests a
possible viral infection such as herpes simplex or varicella which has been implicated, in
some cases, as a trigger for facial palsy.
3. A 9-year-old female patient presents to your clinic with complaints of a headache.
The patients mother states the headache started two days ago and she has been giving
her children's Tylenol. The child states the pain is bilateral and worsens when running or
standing. The nurse practitioner should:
A. Treat her for migraine prevention and start topiramate
B. Order a CT of her head
C. Educate the parent that children need at least 9 hours of sleep
D. Refer to a psychologist for cognitive behavioral therapy - correct answerB.
Table 25-8 lists red flags for pediatric headaches. Headaches that worsen with postural
changes may indicate additional intracranial pathology and should be further
investigated. Depending on the urgency an MRI vs. CT should be considered. A, C, & D
are preventative measures for established migraines or TTH.
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b
pf1c
pf1d
pf1e
pf1f
pf20
pf21
pf22
pf23
pf24
pf25
pf26
pf27
pf28
pf29
pf2a
pf2b
pf2c
pf2d
pf2e
pf2f
pf30
pf31
pf32
pf33
pf34
pf35
pf36
pf37
pf38
pf39
pf3a
pf3b
pf3c
pf3d
pf3e
pf3f
pf40
pf41
pf42
pf43
pf44
pf45
pf46
pf47
pf48
pf49
pf4a
pf4b
pf4c
pf4d
pf4e
pf4f
pf50
pf51
pf52
pf53
pf54
pf55
pf56
pf57
pf58

Partial preview of the text

Download NR577 Exam verified questions and correct answer 2025-2026 and more Exams Nursing in PDF only on Docsity!

  1. A 56-year-old patient comes in for a routine well visit. He has a history of a previous stroke and Type 2 Diabetes. Which of the following orders would be appropriate for a patient with a previous stroke? A. Initiate statin therapy B. EEG C. Warfarin therapy with an INR goal of 2- D. MRI - correct answerA. Patients with a history of an ASCVD should be started on statin therapy regardless of current LDL. The question did not mention any other symptoms that would warrant additional diagnostics. Warfarin therapy is only indicated if AFIB would be the primary indication for anticoagulation after a stroke.
  2. A 36-year-old female is being seen in your clinic for left sided facial weakness. In your review of systems, the patient reports that "certain sounds really bother me and my taste buds seem off". She also reports temporal pain which has subsided. Your physical exam reveals no other neurological deficits. Which of the following interventions would be most appropriate? A. Call 911 to activate emergency stroke protocols B. Refer the patient to neurology C. Order an MRI D. Prescribe a course of oral corticosteroids - correct answerD. Bell's Palsy commonly causes alterations in taste and hyperacusis. This contrasts with stroke. Corticosteroids increase the chances of recovery complete by 12-15% at nine to twelve months and are routinely prescribed. The complaint of pain also suggests a possible viral infection such as herpes simplex or varicella which has been implicated, in some cases, as a trigger for facial palsy.
  3. A 9-year-old female patient presents to your clinic with complaints of a headache. The patients mother states the headache started two days ago and she has been giving her children's Tylenol. The child states the pain is bilateral and worsens when running or standing. The nurse practitioner should: A. Treat her for migraine prevention and start topiramate B. Order a CT of her head C. Educate the parent that children need at least 9 hours of sleep D. Refer to a psychologist for cognitive behavioral therapy - correct answerB. Table 25-8 lists red flags for pediatric headaches. Headaches that worsen with postural changes may indicate additional intracranial pathology and should be further investigated. Depending on the urgency an MRI vs. CT should be considered. A, C, & D are preventative measures for established migraines or TTH.
  1. You are educating the parents of a 16-year-old boy who has been newly diagnosed with epileptic syndrome. Which statement is false? A. Most states will grant a driver's license if the patient has been deemed seizure free for 6-12 months by his physician. B. Clinical seizures that last 15 minutes are considered medical emergencies C. Physical training such as weight training should be restricted due to safety concerns. D. Depression is a common comorbidity of epilepsy. - correct answerC. Physical activity that promote age appropriate socialization and normalcy are highly recommended. The only activities that come with restrictions are scuba diving, contact sports (may or may not be allowed depending on the physician), and free climbing. Swimming is allowed, but preferably under supervision.
  2. A 25-year-old male presents to the clinic complaining of a severe, throbbing headache for the past 2 days. The pain increases when exposed to bright lights and is accompanied by nausea. He states the headache started after working a 16-hour shift without resting. What type of headache is the patient suffering from and what medication is appropriate for immediate relief? A. Migraine headache - Zolmitriptan 5mg PO one dose now, repeat after 2 hours if no relief B. Migraine headache - Topiramate 50mg BID C. Tension - Type Headache - Zolmitriptan 5mg PO one dose now, repeat after 2 hours if no relief D. Cluster headache - Sumatriptan 6mg SQ single dose - correct answerA. Migraine headaches can be unilateral and are often accompanied by nausea, vomiting, and photophobia. These headaches can be triggered by lack of sleep and stress. Zolmitriptan is often effective for immediate relief of migraines. Topiramate is used as a prophylaxis for migraines. The patient's symptoms are not characteristic of a tension type or cluster headache. Triptans are not recommended for tension type headaches.
  3. A 63-year old male presents to clinic with complaints of tremors and muscle spasms. The patient has a history of Parkinson's disease and has been taking Levodopa 50mg TID. What is an appropriate treatment plan for this patient? A. Decrease the amount of levodopa the patient is taking per day. B. Inform the patient that these side effects are common as Parkinson's disease progresses and start the patient on amantadine. C. Refer the patient to a neurologist for further evaluation. D. Continue to monitor the patient for increase in tremors. - correct answerB. Levodopa-induced dyskinesias are common in later Parkinson's disease. Dyskinesias can occur in the form of chorea, tremors, tics, and dystonia. According to Papadakis and McPhee (2018), although levodopa-induced dyskinesias are dose related,

microcephaly and loss, in addition to infant and newborn blindness and neurologic problems.

  1. A 67-year-old female comes into your clinic stating that her daughter just gave birth to her first grandchild and she if planning to fly to visit them next month. She reports her daughter told her to make sure her immunizations were up to date as her grandchild was 2 months premature. She wants to know what immunizations she needs as she has not had any "since high school". You advise her to get which of the following immunizations? A. Influenza, MMR, PCV 13, Herpes Zoster, Tdap B. Influenza, PCV13, Herpes Zoster C. MMR, PCV13, Herpes Zoster D. Influenza, Herpes Zoster - correct answerA. The CDC and The Advisory Committee on Immunization Practices (ACIP) recommend routine influenza vaccination for all persons aged 6 months and older. The ACIP recommend one dose of MMR for non-high-risk adults aged 18 years and older. PCV 13 is recommended for those 65 and older. Increasing reports of pertussis among US adolescents, adults, and their infant contacts have stimulated vaccine development for older age groups. The ACIP recommends Tdap for those age 65 years and older who are around at-risk infants such as those with prematurity. The ACIP also recommends Herpes Zoster vaccination at age 50.
  2. A 55-year-old male presents for a new patient visit. The patient reports he last saw a provider 10 years ago when his wife made him see a doctor for a "pill to quit smoking," as he had tried to quit smoking many times since starting at age 18. He tells you that he has not smoked since that visit and wants to know if he should be screened for lung cancer. Which of the following statements should you make? A. "Since you have not smoked in a decade, you are no longer at risk for smoking associated lung cancer". B. "Unless you are having issues with your breathing, there is no need to screen for lung cancer." C. "Since you smoked for so long, I will send you for a CT of your chest to screen for lung cancer" D. "Unfortunately, there is no screening available for lung cancer". - correct answerC. USPSTF recommends low-dose CT in smokers aged 55-80 years old with a 30-pack year smoking history or prior smokers with this history who have quit in the last 15 years.
  3. When ordering outpatient imaging studies for a patient who has a medical history of Stage IV renal failure, a nurse practitioner would be wise to avoid which study?

a. 2 view chest XRAY b. CT angiography abdomen and pelvis c. MRI brain d. CT c-spine - correct answerB. Radiographic contrast media is directly nephrotoxic and is one of the leading causes of acute kidney injury. Those with preexisting kidney disease pose the greatest risk of significant nephropathy if given this contrast media. Of the listed imaging options, only the CT angiography uses the contrast media and a patient with a history of renal failure should not receive this agent. (Papadakis & McPhee. Current Medical Diagnosis and Treatment, 2019. Pg. 932.)

  1. A common complication of chronic kidney disease is: a. hypotension b. metabolic alkalosis c. hypokalemia d. anemia - correct answerD. decreased erythropoietin production is a complication of chronic kidney disease, typically presenting in stage III. This results in anemia. Additional complications of chronic kidney disease include hypertension, metabolic acidosis, and hyperkalemia
  2. According to the World Health Organization, exclusive breast-feeding is recommended for: a. the first two months of life b. the first six months of life c. the first ten months of life d. the first 12 months of life - correct answerB. because of optimal nutrition for a normal, healthy infant, exclusive breast-feeding is recommended for approximately the first six months of life, then slowly introducing complementary foods through age two.
  3. The current recommendations from the National Heart, Lung, and Blood institute advise to screen all children for hyperlipidemia between the ages of: a. 1-3 years. b. 4-6 years. c. 9-11 years. d. 14-16 years. - correct answerC. current recommendations advise screening for hyperlipidemia between ages 9-11, before the onset of puberty; however, if the child has additional risk factors such as diabetes or obesity, screening should be performed
  4. A 15-month-old child who attends day care 3 times a week comes to the clinic. The patient's mother states that the patient had an episode earlier today where she "shook"

C. Appendicitis D. Cholecystitis - correct answerC. A. This disease is characterized by chronic abdominal pain that has alterations in bowel habits for more than 6 months. Symptoms include indigestion, chest pain, HA, fatigue, gynecologic symptoms and urologic dysfunction. B. Associated with noninflammatory diarrhea that affects the small intestine and interferes with the water and salt balance which is caused by viruses or toxins and is associated with large amounts of watery diarrhea, nausea, vomiting, and cramps. C. *Almost all patients have nausea with one or two episodes of vomiting. There is localized tenderness with guarding in the right lower quadrant and can be elicited with gentle palpation with one finger. There is tenderness or rigidity at McBurney's point and the psoas sign and obturator sign are indicative of inflammation and strongly suggestive of appendicitis. D. This disease is caused by a large or fatty meal and characterized by a sudden appearance of pain located in the epigastrium or hypochondrium. Associated with right upper quad tenderness and muscle guarding with rebound tenderness.

  1. A 35- year-old man presents to the clinic with a complaint of abdominal cramping with bouts of bloody diarrhea. Symptoms began 1 week ago, and the patient has been having to wear adult briefs due to fecal urgency. The NPs differential diagnosis is acute ulcerative colitis. What diagnostic procedure would need to be performed to make an official diagnosis of acute ulcerative colitis? A. Plain abdominal films B. Sigmoidoscopy C. Colonoscopy D. Barium Enema - correct answerB. A. Plain abdominal films are only specified in patients with severe colitis to look for colonic dilation. B. *In acute ulcerative colitis, the diagnosis is established by performing a sigmoidoscopy. The intestinal mucosa appears edematous, friable, presence of mucopus and erosions. C. Colonoscopy is contraindicated in acute ulcerative colitis due to the risk of perforation. After patients have improved on therapy, then a colonoscopy can be performed to determine the degree of the disease. D. Barium enema has no use in acute ulcerative colitis and may create toxic megacolon in severe ulcerative colitis.
  2. Nurse Practitioners understand that disease prevention is divided into different categories. Which of the following options listed would be categorized as a form of secondary disease prevention: a. Annual Flu vaccine

b. Routine cervical Papanicolaou screening c. Radiation therapy to control localized breast cancer d. Providing information on smoking cessation - correct answerB. A. Flu vaccine is a form primary prevention which aims to reduce or remove disease risk. B. Correct answer. Secondary prevention is aimed at early disease detection. A routine cervical pap screening is aimed at the early detection of cervical dysplasia or carcinoma. C. Radiation therapy to control breast cancer is a form of tertiary prevention which is aimed at limiting disease impact. D. Information on smoking cessation is a form of primary prevention.

  1. The Nurse Practitioner would recommend all of the following cancer screenings EXCEPT: a. A mammogram for a 58-year-old female whose last mammogram was 2 years prior to screen for breast cancer. b. An annual low-dose CT for a 60-year-old male who quit smoking cigarettes 2 years ago with a 30-pack-year smoking history whose last screen was 1 year prior to screen for lung cancer. c. A colonoscopy for a 65-year-old female whose last colonoscopy was 10 years prior to screen for colorectal cancer. d. A cervical cancer screening with HPV testing on a 24-year-old female whose last PAP was 3 years prior. - correct answerD. A. The USPSTF recommends biennial mammograms for women aged 50-74. B. The USPSTF recommends Annual low-dose CT scans for current smokers aged 55- 80 with a 30-pack-year history of smoking or who have quit within the past 15 years. C. The USPSTF recommends colonoscopies every 10 years for individuals aged 50-75. D. The USPSTF does not recommend cervical cancer screenings with HPV in women younger than 30 years.
  2. Regarding blood pressure in pediatric patients, all of the following are correct EXCEPT: a. Hypertension can be diagnosed after 2 elevated manual blood pressure readings within a single office visit. b. Blood pressure measurement at a well-child visit starts at 3 years of age. c. Cuffs that are too wide will underestimate the true blood pressure while cuffs that are too narrow will overestimate the true blood pressure. d. Children with repeated blood pressure readings from the 90th to the 95th percentile are classified as having prehypertension. - correct answerA.

resolved. She has tried simple OTC analgesics and lidocaine patches for pain. What is the next line of therapy? a. Oxycodone 10 mg by mouth every four hours as needed b. Gabapentin 300 mg by mouth three times daily c. Duloxetine 60 mg by mouth daily d. Amitriptyline 25 mg by mouth nightly - correct answerD. According to Papadakis and McPhee (2017), post herpetic neuralgia is more common in patients over the age of 55 who have have trigeminal involvement. Amitriptyline and other tricyclic antidepressants are the first line therapy after simple analgesics have been tried. Gabapentin, Duloxetine, and long acting opioids may be added if relief is not met.

  1. A one-time screening for an abdominal-aortic aneurysm (AAA) by ultrasound is recommended for which of the following patient populations? Select one A. screening for abdominal-aortic aneurysm is not recommended B. non-smoking females 65- C. all male and female patients at age 60 D. all males aged 65-75 who have ever smoked - correct answerD. The one-time screening is recommended for all men 65-75 who have ever smoked and recommended selectively for men age 65-75 that have never smoked. The screening has resulted in a 50% decrease in mortality related to a AAA in men aged 65-75. This screening is not shown to be beneficial for women who have never smoked, and there is no recommendation at this time for women that are age 65-75 that have smoked or currently smoke
  2. A 55-year-old female with obesity visits your clinic for the first time. You are concerned that she may have metabolic syndrome. Which of the following findings would not be diagnostic of metabolic syndrome in this patient? A. a waist circumference 30 inches B. fasting glucose 110 mg/dL C. triglyceride level of 200 mg/dL D. a blood pressure of 150/85 - correct answerA. To be diagnosed with metabolic syndrome, a patient must have at least 3 of the 5 following attributes: (1) blood pressure of 130/85 or greater (2) HDL cholesterol less than 40mg/dL in men or 50mg/dL in women (3) triglyceride level of 150mg/dL or more (4) fasting blood glucose levels of 100mg/dL or more (5) waist circumference of 40in or greater in males or 35in or greater in females. Metabolic syndrome increases a patient's risk of developing co-morbidities such as type 2 diabetes, stroke, heart disease, and obstructive sleep apnea
  3. Which of the following is considered a secondary prevention?

A. Smoking cessation B. Flu vaccine C. Mammogram D. Radiation therapy for breast cancer. - correct answerC. Secondary preventions include techniques that promote early detection of disease

  1. When counseling a patient who reports that they are not physically active, clinicians are suggested to use the "5 A's" to evaluate and treat the patient. Which of the following represents the order the FNP would address the patient? A. Ask, Assess, Advise, Assist, and Arrange B. Assess, Ask, Advise, Assist, and Arrange C. Ask, Assess, Assist, Arrange, and Advise D. Ask, Assist, Assess, Arrange, and Advise - correct answerA. The "5 A's" approach is used to aid clinicians in evaluating, assisting, and treating patient's that are not physically active. To use this approach the clinician should 1. Ask (find those who could benefit) 2. Assess (evaluate current activity status) 3. Advise (create a patient-specific plan) 4. Assist (Prescription for exercise or support material).
  2. Arrange (Referral and follow up).
  3. A 3-year-old Hispanic male presents to the clinic with his mother ho states that the patient has had a loss of appetite, vomiting, fever, abdominal pain, dark urine, and clay colored stools. On the physical exam the FNP notices tender hepatomegaly. The mother reports a recent move from Guatemala to the United States last month. What diagnosis does the FNP suspect? A. Pancreatitis B. Hepatitis A C. Gastroenteritis D. Hepatitis C - correct answerB. Hepatitis A presents with fever, anorexia, vomiting, headache, abdominal pain, and dark urine. Tender hepatomegaly is usually present in children with symptoms. The patient recently moved from a country where Hepatitis A is prevalent.
  4. A 19-month-old female presents to the clinic with her mother for evaluation. She was found to have a positive anti-HCV IgG. What would be the next step for the FNP? A. Order an abdominal ultrasound. B. Recheck anti-HCV IgE when the patient turns 2. C. No further testing. This is a normal finding. D. Order HCV RNA to determine if there is an active infection. - correct answerD. Patient's that are older than 18 months old with a positive anti-HCV IgG should have HCV RNA testing done in order to determine if the patient has an active infection

bigger. He also has a few moles that are similar on his face and neck. What would the NP suggest to the patient? A. These moles are most likely a benign growth called seborrheic keratosis. If they are bothersome, cryotherapy could be utilized as a treatment choice. B. Freckles tend to get bigger and change color as we age. Use sunscreen to protect them. C. These moles are concerning for malignant melanoma. A referral to dermatology for closer evaluation is strongly recommended. D. Melanocyti - correct answerC. The patient at increased risk for malignant melanoma are over 50 years of age, white and have recreational sun exposure. The history of the evolution of the mole is the most important historical reason for dermatology referral.

  1. A 23-year-old female patient comes to the clinic to be seen for a rash on her upper legs that developed two days ago. She went away for the weekend with friends and spent time in a hot tub. She describes the rash as burning and itchy. She denies any other symptoms. On examination, the NP notes tender follicular, pustular lesions on her bilateral upper legs. What is the diagnosis? A. Folliculitis B. Contact dermatitis C. Impetigo D. Pustular miliaria - correct answerA. folliculitis is most likely due to Pseudomonas aeruginosa as the patient was recently sitting in a hot tub and is highly suggestive of Pseudomonas folliculitis. The other diagnoses do not correlate with the H&P.
  2. A 6-month-old female with a history of allergic rhinitis & a mother with asthma presents to the clinic with pruritis and dry skin patches in the antecubital skin creases over the last month. The NP knows that the likely diagnosis is: A. Tinea Versicolor B. Varicella-Zoster Infection C. Folliculitis D. Atopic Dermatitis - correct answerD. The essential clinical Signs and Symptoms of atopic dermatitis are pruritis in the past 12 months, plus three of the following: history of dry skin in the past 12 months, personal history of asthma, if <4 years of age has a first-degree family member with diagnosis of asthma or allergic rhinitis, onset of signs and symptoms prior to 2 years of age, visual flexural dermatitis, or skin crease involvement. This infant has pruritis plus three of the other features making this the correct diagnosis
  1. A 5-year-old male presents to your clinic with honey-crusted lesions located on the bridge of the nose and the upper lip. The NP knows that the best treatment for these lesions is: A. No treatment is necessary because the lesions will go away on their own. B. Prescribe Mupirocin topical ointment and Clindamycin PO x 10 days C. Prescribe Acyclovir x 7 days D. Prescribe Diflucan because a fungus causes the infection. - correct answerB. Impetigo is defined as honey-crusted erosions that are treated with topical Mupirocin, Polymyxin, Gentamycin, and Erythromycin ointment. Oral therapy includes the beta- lactamase-PCNs or Cephalosporins to treat Staphylococcus aureus such as Clindamycin or Augmentin for 7-10 days
  2. While educating a mother about her 6-month-old at a well child check-up about vaccines, the nurse practitioner says which of the following correct statements? A. "Your child is now due for a Varicella vaccine". B. "The 3rd dose of Tdap in the 5-dose series is due today". C. "Your child does not need the Influenza vaccine until she is 1 year old". D. "The 3rd dose of the Hepatitis B vaccine can be given as early as 6 months old". - correct answerD.
  3. The Hepatitis B Virus (HBV) is most likely to be transmitted by A. intravenous (IV) drug use while sharing needles. B. blood transfusions. C. consuming food or water contaminated by the virus. D. sharing eating utensils with someone infected. - correct answerA. HBV is transmitted by IV drug use while sharing needles, men who have sex with men and heterosexual partners who are infected, neonates born to infected mothers, contact with blood or open sores of an infected person, needle sticks or sharp instrument exposures, and sharing razors or toothbrushes with an infected person
  4. An 18-month old presents to the clinic today for a well-child visit. Which of the following screenings should be performed at this visit? A. Visual acuity screening B. Lead screening C. Autism screening D. Anemia screening - correct answerC.
  5. A 4-year old presents to the clinic today for a yearly well-child visit. Which of the following screenings should be performed at this visit? A. Hearing screening B. Lead screening

D. Achieving healthy eating, changing activity patterns, and family involvement. - correct answerD. The goal for children that are obese is to attain healthier eating habits as well as activity patterns. Treatment that involves the family has been associated with persistent weight loss and a decline in BMI. Children 2-5years old with a BMI >95% should lose 1lb/month. Pharmacotherapy by itself is not likely to sustain weight loss or result in significant weight loss

  1. A 53-year-old male comes into your clinic with a history of chronic kidney disease with a GFR of 60 and a history of hypertension. The patient is currently taking HCTZ 12.5mg po daily as well as Lisinopril 10mg po daily. What other medication would you start your patient on to help reduce the risk of a cardiovascular event? A. Valsartan 80mg po daily B. Atorvastatin 20mg po daily C. Amoxicillin 500mg po BID D. Zetia 10mg po daily - correct answerB. patients with CKD stage 1-2 (or a GFR of 60-90) should be treated aggressively with statins to help reduce their cardiovascular disease risk. Atorvastatin is the correct answer to help reduce the patient's risk of a CV event. Although Valsartan would be appropriate, the patient is already on an ACE inhibitor. Zetia would be appropriate as well but only if it is with a statin and is usually only used in combination with a statin for stages 3-5, non-dialysis patients.
  2. A GFR of <___ for ___ or more months along with hyperkalemia, anemia and persistent proteinuria on urine dipstick is indicative of what? A. 30; 3; glomerulonephritis B. 45; 6; acute kidney disease C. 15; 9; polycystic kidney disease D. 60; 3; chronic kidney disease - correct answerD. A patient who has chronic kidney disease has a GFR of <60 for 3 or more months as well as having markers of kidney disease such as hyperkalemia, anemia and persistent proteinuria on urine dipstick.
  3. A mother brings her 5-month-old daughter to your clinic and states she has been fussy all night and "feels hot" this morning. She has not given her any medication this morning. Upon assessment you notice that the baby has a temperature of 103.1°F and is crying. What would be the appropriate treatment for the patient's fever today? A. Ibuprofen 10mg/kg once now B. Acetaminophen 15mg/kg once now C. Combination of Ibuprofen and Acetaminophen due to the high fever once now

D. Choose either Acetaminophen or Ibuprofen now and instruct the mother to begin alternating the two medications at home as long as fever persists. - correct answerB. the treatment for fever of 39°C (102.2°F) or for discomfort is Acetaminophen 15mg per kg of weight. Ibuprofen is only indicated for children older than 6 months. Combining Acetaminophen and Ibuprofen is also incorrect for the same reason. It is not recommended, no matter what the age, to alternate Acetaminophen and Ibuprofen for fever.

  1. A 4-year-old male presents to your clinic with a 2-day history of vomiting, diarrhea, and anorexia. His parents are concerned that he may be dehydrated. Which of the following is NOT an essential assessment when looking for signs of dehydration in the pediatric patient? a. Capillary refill b. Mucous membranes c. Presence of protein in the urine d. Decrease in body weight - correct answerC. clinical manifestations of dehydration in the pediatric patient include significant weight loss, skin changes such as poor turgor or pale color, dry mucous membranes, increased pulse rate, decreased capillary refill or blood pressure (in severe dehydration), decreased urinary output or tear production, and increased urine specific gravity or low urine sodium. The presence of protein in urine would indicate damage or problems with kidneys.
  2. An 11-year-old female is brought to your clinic complaining of fatigue, weakness, and nausea. She spent the previous weekend out of town competing in a softball tournament. Her mother states that her urine is dark, she has been laying around, and hasn't been herself for the past 2 days. Upon assessment you note that her mucous membranes are dry. Her pulse is 110 and blood pressure is 115/66. You obtain a urinalysis and note her urine is amber colored but clear, and the specific gravity is 1.040. What is your most appropriate plan or teaching for this patient? a. Instruct the mother to encourage frequent small sips of an electrolyte enhanced drink over the next 1-2 days until symptoms improve. b. Suggest that the patient try to consume broths or sodas in place of solid food to increase nutrients. c. Send patient to ED because she needs IV fluids to improve dehydration. d. Encourage patient to take large swallows - correct answerA. this patient would be considered to have mild to moderate dehydration based on finding such as dry mucous membranes, tachycardia, and high urine specific gravity. The patient's blood pressure is within normal limits. It is suggested to take small frequent sips of electrolyte enhanced drink at approximately 50mL/kg over 4 hours for mild dehydration. Broths, soups, sodas, juice, tea, etc. are contraindicated for the treatment

c. Because your infant has a history of mild eczema, it is recommended to have allergy sensitivity testing prior to introducing peanut proteins to determine if peanut-containing food should be introduced at all. d. The history of eczema does not impact the recommendation for introducing peanut containing foods. Early introduction of peanut-containing foods is associate - correct answerB. Infants with mild-to-moderate eczema are advised to begin introducing peanut purees and peanut containing foods at approximately 6 months of age to reduce the risk of peanut allergens. If the infant had severe eczema or an allergy to egg, considering peanut specific IgE sensitization testing is strongly recommended prior to introducing peanut protein. If the peanut sensitization testing is negative, it is recommended to introduce peanut protein in puree form between ages 4-6 months. It is hypothesized that early introduction of peanut-containing foods is associated with a lower risk of developing a peanut allergen, but the timing of introduction of these foods is dependent on the patient's history of eczema and egg allergy

  1. A healthy 4-year-old comes in for his annual well visit. As his provider, you know that there are precise growth parameters that should be plotted and evaluated on a sex- specific growth chart. Which specific growth parameters are measured at a 4-year-old well visit. a. Weight, height, head circumference, body mass index b. Weight, height, body mass index, hearing and vision, and blood pressure. c. Weight, height, head circumference, hearing and vision d. Weight, and height only. - correct answerB
  2. A mother brings her 4-month-old baby into the office complaining of a terrible cough and congestion for a couple days and a fever that began this morning. The patient test positive for RSV only. Which medication is the best choice for this patient? a. Ibuprofen b. Tylenol c. Keflex d. Amoxicillin - correct answerB
  3. All of the following patients take high priority for the influenza vaccine during flu season EXCEPT:
  4. 32-year-old female who is 6 months pregnant
  5. 28-year-old female with no past medical history
  6. 60-year-old male who resides at local nursing home
  1. 45-year-old male who has a history of uncontrolled diabetes mellitus - correct answerB. Influenza vaccine should be given to all age groups during influenza season for prevention of flu. However, high priority goes to adults 50 years old and older, women who are pregnant and individuals who have chronic illnesses or are immunocompromised.
  2. Which of the following is an example of primary prevention for cervical cancer? a. HPV vaccine b. Annual Pap Smear c. Pelvic ultrasound d. Chemotherapy - correct answerA.
  3. When should an infant, born to a mother with an unknown Hepatitis B status, receive their first Hepatitis B immunization? A. At their 2 months well visit. B. Within 12 hours of birth. C. At birth, with the first dose prior to 24 hours of age. D. They should receive Hep B and HBIg immediately after birth. - correct answerB.
  4. A 6-month-old baby girl presents to your office for a well visit. She is up to date on all previously, required vaccinations. Which vaccinations do you anticipate ordering today? A. No vaccinations today. B. Influenza, PCV 13, Hepatitis B, and Hib. C. Hepatitis B, DTaP, Rotavirus, and Hib. D. Influenza, Hepatitis B, DTaP, Hib, Inactivated Polio, Rotavirus, and PCV 13. - correct answerD.
  5. When treating a pediatric patient who is overweight or obese, the nurse practitioner understands that the best treatment is based on not only risk factors, such as age, severity of obesity, comorbidities, and family history, but also the health promotion strategy of _____________. A. Motivational interviewing. B. Individually based behavior modifications. C. Presenting power point slideshows. D. Parental regulation of all meals. - correct answerA. The primary goal for pediatric overweight/obesity treatment is the achievement of healthy eating and physical activity habits. Treatment geared towards behavior changes as well as family involvement have been associated with the greatest results. Motivational interviewing techniques are helpful with insusceptible families to foster