Issues in Primary Care

1. Question: Because of the potential for exploitation of older adults, the geriatric population is designated a vulnerable one when it comes to obtaining informed consent for serving as a research subject. Safeguards you should adhere to when conducting research on a geriatric population include which of the following? 
2. Question: If conflict arises during a job negotiation, you should consider: 
3. Question: Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. This means that the: 
4. Question: Elder abuse and neglect are increasing concerns, and it is estimated that 4% to 10% of older Americans are abused or neglected. What is the legal responsibility of the health care provider in reporting elder abuse and neglect? 
5. Question: Relapse is a common phenomenon seen during behavioral changes. Useful strategies for the health care provider to institute to aid the client in a relapse situation include:
6. Question: Mrs. Smith, age 85, lost her husband 6 months ago. Since that time, she has been overwhelmed and has had difficulty coping. Today, she is in your office, tearful, weak, and discouraged. Her mobility is also becoming increasingly limited because of her need for a hip replacement. She is indecisive, expresses fear about the surgery, and tells you she does not want the surgery. Your best action is to: 
7. Question: The Affordable Care Act (ACA) passed in 2010 has a number of provisions, including the establishment of health exchanges. The purpose of a health insurance exchange is to: 
8. Question: It is important to do which of the following before negotiating a contract? 
9. Question: Health behaviors can be difficult to change. Which of the following is most important in influencing behavioral change? 
10. Question: There are advantages to owning your own practice. However, there are also barriers to the ability to do this. These barriers include which of the following? 
11. Question: Mr. Griffin, age 85, has been given a diagnosis of bowel cancer, and surgery is indicated. He is mentally alert; however, he is refusing to give consent for the procedure. You respond by: 
12. Question: The term credentialing means that: 
13. Question: When caring for a client who speaks a language different from yours, the ideal strategy is to: 
14. Question: The best way you, as an individual advanced practice registered nurse (APRN), can make a difference or real impact is by: 
15. Question: Which of the following nonverbal communication techniques is important in the establishment of rapport with a client? 
16. Question: It is important to prepare for your interview as an advanced practice registered nurse (APRN). You should be prepared to answer which of the following? 

17. Question: The research function of the advanced practice registered nurse (APRN) may be operationalized as both a consumer of research findings and a researcher. Being a consumer of research findings involves a number of activities, including: 
18. Question: Mr. Jones, age 44, is admitted to the emergency department complaining of chest pain. Which of the following actions would be the best way to establish a therapeutic relationship with Mr. Jones? 
19. Question: As an advanced practice registered nurse (APRN), you begin a new job in a small practice with 2 other physicians. You have been hired to be a partner in the practice, but the eldest partner is reluctant to allow you to take on new clients. This is an example of: 
20. Question: Certain characteristics differentiate research from quality improvement. Which of the following is an example of research? 
21. Question: You are working in an emergency department as an advanced practice registered nurse (APRN). An adolescent boy is brought in, unconscious, with a head injury after being struck by a car. He has no identification, and there is no parent or adult with him. What should you do? 
22. Question: You are attempting to elicit a history from Mr. Barnes during his first visit to your office. He is becoming increasingly angry and belligerent. He says, “Can’t you hurry up? Dr. Smith never takes this long! Why are all these questions necessary?” You respond: 
23. Question: Mr. Brill, age 50, is a house painter who has smoked 2 to 3 packs of cigarettes per day since he was 20 years old. He comes in to the clinic complaining of a chronic cough. When you discuss his smoking behavior, he states, “I know I need to stop smoking, but I’m under too much stress right now.” Mr. Brill is at which stage of change? 
24. Question: Your client is convinced her illness has been caused by the ill will of a family member. Her description of her illness is an example of her: 
25. Question: Which of the following statements about Medicaid is true? 
26. Question: The term indemnity insurer refers to an insurer: 
27. Question: What must you do as an advanced practice registered nurse (APRN) before billing for visits? 
28. Question: Negligence is the predominant legal theory of malpractice liability. Negligence includes: 
29. Question: Prescriptive authority for advanced practice registered nurses (APRNs): 
30. Question: Which of the following statements best describes the term patient engagement? 
31. Question: Which of the following describes a situation in which medical information may be passed on without client consent? 
32. Question: Mrs. Hernandez, age 79, is insisting on discharge from the skilled nursing facility where she is receiving rehabilitation after a left hip replacement. She lives alone and has very little support. You do not think she is ready for discharge. Mrs. Hernandez’s insistence on discharge is an example of your client exercising her right to: 
33. Question: Which of the following strategies can help foster client compliance? 
34. Question: The term collaboration is best defined as: 
35. Question: You are seeing your client for the first time, and he says, “I like that you are a physician assistant.” You tell him you are a nurse practitioner, and he asks you how the two are different. Your best answer is:

Health Promotion, Diagnosis, Treatment, and Evidence-Based Practice

1. Question: Which of the following is not a modifiable risk factor? 
2. Question: In relation to writing a patient encounter note, the acronym SOAP stands for which of the following words? 
3. Question: Which of the following is not a subjective finding? 
4. Question: Which of the following doesn’t fall under the umbrella of health promotion as a nurse practitioner? 
5. Question: Which of the following statements about health promotion is false? 
6. Question: What intervention would not be included in the definition of secondary prevention? 
7. Question: As a nurse practitioner, which of the following would not be an example of primary health promotion? 
8. Question: Which of the following refers to an aspect of a patient’s health that cannot be changed or affected by a health intervention? 
9. Question: Which of the following patients is health literate? 
10. Question: Between ages 7 and 18, both boys and girls are immunized against the following diseases: 
11. Question: The OLD CARTS (onset, location, duration, character, aggravating/alleviating factors, radiation, timing, severity) mnemonic is best used in which part of your chart note? 
12. Question: Mark, a 56-year-old man, comes to your practice seeking help quitting smoking. You prescribe varenicline (Chantix), a prescription medication, to aid with his attempt. What instructions do you give Mark regarding how to stop smoking with Chantix? 
13. Question: Margaret, age 29, is of medium build and 5 ft 4 in tall. You estimate that she should weigh about: 
14. Question: Martha, age 82, has an asymptomatic carotid bruit on the left side. What do you recommend? 
15. Question: Sandy, a 68-year-old woman, presents to your office for screening for osteoporosis. She states that her grandmother and mother both lost inches in their old age. She has been postmenopausal for the past 15 years and never took any hormone replacement medications. She is Caucasian, weighs 108 lb, and is 5 ft 1 in tall on today’s measurement. When do women lose the greatest amount of bone density? 
16. Question: When performing a sports physical exam on Kevin, a healthy 16-year-old boy, which question in the history is important to ask Kevin or his guardian? 
17. Question: If a screening test used on 100 individuals known to be free of breast cancer identified 80 individuals who did not have breast cancer while missing 20 of the individuals, the specificity would be: 
18. Question: Harvey, age 55, comes to the office with a blood pressure (BP) of 144/96 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the examination, it remains 144/96. What should your next action be? 
19. Question: Julia, age 18, asks you how many calories of fat she is eating when 1 serving has 3 g of fat. You tell her: 
20. Question: Which of the following individuals should get the shingles (herpes zoster) vaccine? 
21. Question: As a primary care provider, which of the following topics is not typically important for adults aged 20 to 40? 
22. Question: Which of the following refers to an aspect of a patient’s health that can be changed or affected by a health intervention? 
23. Question: Which of the following statements does not belong in the past medical history portion of your chart note? 
24. Question: Documentation in your patient’s chart is important for all the following reasons except? 
25. Question: Telehealth has shown a drastic increase in utilization by patients in which of the following fields of medicine? 
26. Question: A nurse practitioner is practicing based on the rule-based actions he was taught in school and doesn’t understand when/where those rules may be inappropriate. Which following statement best describes this skill level? 
27. Question: How often should you receive a Tdap booster when no injury history is present? 
28. Question: Mildred, an independent 92-year-old woman, is moving into her daughter’s home. Her daughter comes to see you seeking information to help keep her mother from falling. Which of the following interventions would you suggest she do to help prevent Mildred from falling? 
29. Question :Joseph, a 55-year-old man with diabetes, is at your office for his diabetes follow-up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Joseph receive today regarding the care of his feet? 
30. Question: How do you respond when Jill, age 42, asks you how long she should work out each week? 
31. Question: Sandra, a 27-year-old nurse, states that she does not want to get the hepatitis B virus vaccine because of its adverse effects. You tell her that the most common adverse effect is: 
32. Question: Dennis, age 62, has benign prostatic hyperplasia (BPH). He tells you that he voids at least 4 times per night and that he has read about a preventive drug called terazosin hydrochloride (Hytrin) that might help him. What do you tell him? 
33. Question: You are sharing with your client the idea that he needs to get some counseling to deal with his severe stress because it is affecting his physiological condition. Which of the following hormonal changes occurs during severe stress? 
34. Question: Which of the following demonstrates a subjective finding? 
35. Question: The study of the way diseases are spread through groups and what causes and helps spread these diseases is called? 
36. Question: Which of the following statements does not belong in the past medical history portion of your chart note? 
37. Question: You have a patient who presents with ankle pain. Which of the following facts or observations does not belong in the physical exam portion of your note? 
38. Question: Telehealth has shown a drastic increase in utilization by patients in which of the following fields of medicine? 
39. Question: What type of reaction following an immunization is considered serious and requires reevaluation? 
40. Question: Mary, a 70-year-old woman with diabetes, is at your office for her 3-month diabetic checkup. Mary’s list of medications includes metformin (Glucophage XR) 1000 mg daily, an angiotensin-converting enzyme (ACE) inhibitor daily, and 1 baby aspirin (ASA) daily. Mary’s blood work showed a fasting blood sugar (FBS) of 112 and glycosylated hemoglobin (HbA_1c) of 6.5. You tell Mary that her blood work shows: 
41. Question: For which patient would you administer the human papillomavirus (HPV) vaccination?