13-Questions Appeared Twice on the Test

1. Question: A 55-year-old patient develops Parkinsonss disease characterized by unilateral tremors only. The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:
2. Question: A 70-year-old patient describes moderate to severe pain associated with osteoarthritis in fingers, thumbs, hips, and knees. The patient is currently taking high-dose acetaminophen. The patient has a strong family history of cardiovascular disease and has been diagnosed with hypertension. To help a patient with mild to moderate osteoarthritis pain has been taking acetaminophen for pain. The primary care NP prescribes a nonselective NSAID. At a follow-up visit, the patient reports mild GI side effects. The NP should:
3. Question: A child is diagnosed with AD/HD after being expelled from school for disruptive behaviors. The child’s parents are reluctant to start medication because of the stigma attached. The primary care NP should suggest:
4. Question: A child is taking methylphenidate (Ritalin) for AD/HD. The childss parent calls the primary care NP to report increased behavior problems and delusional thinking. The NP should:
5. Question: A patient exhibits keratin deposits around hair follicles and has hardened pigmented "goose bump" lesions on all extremities. The primary care NP should consider prescribing:
6. Question: A patient has confirmed Rocky Mountain spotted fever, and the infectious disease specialist is treating the patient with doxycycline 100 mg orally for 7 days. The patient comes to the clinic for follow-up care with the primary care NP at the end of therapy and reports continued fever, headache, and myalgia. The NP will consult with the infectious disease specialist and order:
7. Question: A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness. The patient’s aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should:
8. Question: A patient is identified as having stage 2 Alzheimerss disease and elects to take donepezil (Aricept). The patient asks the primary care nurse practitioner (NP) how long the medication will be needed. The NP should tell the patient that donepezil must be taken:
9. Question: A patient who has Alzheimer’s disease has been taking donepezil for 1 year. The patientss spouse reports a worsening of symptoms. The primary care NP should consider:
10. Question: A patient who has Parkinson’s disease who takes levodopa and carbidopa reports having drooling episodes that are increasing in frequency. The primary care NP should order:
11. Question: A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:
12. Question: Early-stage Alzheimer’s disease is diagnosed in a patient, and the primary care NP recommends therapy with a ChE inhibitor. The patient asks why drug treatment is necessary because most functioning is intact. The NP should explain that medication may:
13. Question: The parents of a 3-year-old child tell the primary care NP that their child is a very picky eater and they are worried about the childss nutrition. The NP should recommend:

34-Questions Too Difficult on the Test 

1. Question: A 20-kg child takes valproic acid (Depakote) for seizures and has had regular dose increases with a current dose of 250 mg twice daily. The child continues to have one to two seizures each week along with significant drowsiness that interferes with school participation. The primary care NP should contact the childss neurologist to discuss:
2. Question: A 65-year-old patient is diagnosed with Parkinson’s disease. The patient has emphysema and narrow-angle glaucoma. The primary care NP should consider beginning therapy with:
3. Question: A man who has benign prostatic hypertrophy (BPH), in whom prostate carcinoma has been ruled out, asks the primary care nurse practitioner (NP) about beginning drug therapy to treat his symptoms. The NP notes that he consistently has blood pressure readings around 145/90 mm Hg. The NP should prescribe:
4. Question: A parent brings a 6-year-old child to the clinic for evaluation of a rash. The primary care NP notes three annular lesions with elevated borders and central clearing on the child’s face and a similar lesion on the back of the neck that extends above the hairline. The NP should prescribe:
5. Question: A patient comes to the clinic complaining of low back pain unrelieved by NSAIDs. The patient has a history of angle-closure glaucoma and renal disease. The primary care NP should prescribe:
6. Question: A patient comes to the clinic reporting sudden pain and swelling of one knee joint. The primary care NP suspects gout. When preparing to order diagnostic tests, the most important initial test the primary care NP should order is:
7. Question: A patient has a diagnosis of depression and Alzheimerss disease with mild, intermittent symptoms. The primary care NP should prescribe a(n):
8. Question: A patient has been taking donepezil (Aricept) for several months after being diagnosed with Alzheimer’s disease. The patient’s spouse brings the patient to the clinic and reports that the patient seems to be having visual hallucinations. The primary care NP should:
9. Question: A patient has been taking oral prednisone 60 mg daily for 3 days for an asthma exacerbation, which has resolved. The patient reports having gastrointestinal (GI) upset. The primary care nurse practitioner (NP) should:
10. Question: A patient has been treated for severe contact dermatitis on both arms with clobetasol propionate cream. At a follow-up visit, the primary care NP notes that the condition has cleared. The NP should:
11. Question: A patient has urethritis. The primary care NP should prescribe:
12. Question: A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness. The patient’s aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should:
13. Question: A patient reports feelings of sadness and hopelessness along with difficulty sleeping and weight loss. The primary care NP learns that the patient’s mother died 6 months earlier. The NP should:
14. Question: A patient takes rizatriptan (Maxalt) to abort migraine headaches but tells the primary care NP that the headaches have become more frequent since a promotion at work. The NP’s initial response should be to:
15. Question: A patient was seen in a local emergency department and was treated empirically for pharyngitis with ampicillin and comes to the clinic 2 days later with an urticarial rash. The patient has no previous history of atopy and does not have respiratory symptoms. The primary care NP should suspect:
16. Question: A patient who has been taking medications to treat TB tells the primary care NP that the infectious disease specialist has added ethambutol to the drug regimen. The patient asks the NP for information about this drug. The NP should explain that this drug:
17. Question: A patient who has BPH is taking doxazosin and finasteride. The patient asks the primary care NP whether he has an increased risk of prostate cancer. The NP should tell him:
18. Question: A patient who has HIV has been receiving a two-drug combination therapy for 6 months. At an annual physical examination, the primary care NP notes that the patient has a viral load of 60 copies/mL and a CD4 cell count of 350 cells/mm. The NP should contact the patient’s infectious disease specialist to discuss:
19. Question: A patient who has Parkinson’s disease takes levodopa and carbidopa. The patient asks the primary care nurse practitioner (NP) why two drugs are necessary. The NP should explain that both drugs are needed to:
20. Question: A patient who has recently begun working at night reports having difficulty staying awake at work. The primary care NP should consider prescribing:
21. Question: A patient who has year-round allergic rhinitis uses an intranasal corticosteroid and a daily oral antihistamine. The patient reports persistent watery and itchy eyes. The primary care NP observes profuse clear, watery discharge and a cobblestone appearance inside the upper eyelids, with clear conjunctivae. The patient has tried topical azelastine (Astelin) and topical diclofenac (Voltaren) without improvement. The NP should prescribe _____ drops.
22. Question: A patient who is diagnosed with Alzheimer’s disease experiences visual hallucinations. The primary care NP should initially prescribe:
23. Question: A patient who is taking colchicine for gout is in the clinic 1 week after beginning the medication. The patient reports decreased appetite and nausea. The primary care NP should:
24. Question: A patient will require a long course of steroids to treat a chronic inflammatory condition. The primary care NP expects the specialist to order:
25. Question: A patient with a history of gouty arthritis comes to the clinic with acute pain and swelling of the great toe. The patient is not currently taking any medications. The primary care NP should prescribe:
26. Question: A primary care NP prescribes oxybutynin chloride for an 80-year-old patient to treat urinary incontinence. When teaching this patient about this medication, the NP should tell the patient:
27. Question: A primary care NP prescribes probenecid to treat a patient who has gout. The patient comes to the clinic 2 weeks later with severe flank pain. The NP should:
28. Question: A primary care NP sees a patient who has dysuria, fever, and urinary frequency. The NP orders a urine dipstick, which is positive for nitrates and leukocyte esterase, and sends the urine to the laboratory for a culture. The patient is allergic to sulfa drugs. The NP should:
29. Question: A primary care nurse practitioner (NP) prescribes a topical cream medication. Which statement by the patient indicates understanding of proper application of this medication?
30. Question: A school-age child comes to the clinic with a 5-day history of cough and low-grade fever. The primary care NP auscultates crackles and diminished breath sounds bilaterally. The NP should:
31. Question: An adult patient has cellulitis. The patient is a single parent with health insurance who works and is attending classes at a local university. To treat this infection, the primary care nurse practitioner (NP) should prescribe:
32. Question: At an annual well-woman examination, the primary care nurse practitioner (NP) asks a patient about alcohol consumption. The woman reports she usually consumes six glasses of wine per week and occasionally will consume three or four glasses at a party. The NP smells alcohol on the woman’s breath. The woman says she is hung over today. The NP should:
33. Question: The parents of a 2-month-old infant ask the primary care nurse practitioner (NP) if they can immunize their child by giving one or two immunizations per month instead of following the recommended immunization schedule for vaccines at 2, 4, 6, 12, and 15 months of age. The NP should:
34. Question: The primary care NP sees a 4-year-old child who has persistent asthma episodes for a well-child visit in October. The child recently completed a 7-day course of oral steroids. The NP plans to give the child flu vaccine and should: