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FNP 654 FINAL EXAM 2025 - 2026 ACTUAL SUMMER-
FALL EXAM GCU GRADED A (ANSWERED) 300Q&A
A patient has recurrent cluster headaches and asks about abortive therapy. Which therapy is effective for a majority of patients with cluster headaches? Oxygen A patient who has been exposed to poison ivy presents with inflammation and a vesicular rash on one arm. The provider recommends a topical steroid, but the next day the patient calls to report similar lesions appearing on the face. What will the provider tell this patient? The vesicles may continue to develop for up to 2 weeks. A patient who has recurrent, frequent genital herpes outbreaks asks about therapy to minimize the episodes. What will the provider recommend as first-line treatment? Acyclovir A patient who has never had an outbreak of oral lesions reports a burning sensation on the oral mucosa and then develops multiple painful round vesicles at the site. A Tzanck culture confirms HSV-1 infection. What will the provider tell the patient about this condition? The initial episode is usually the most severe. A patient who has had lesions for several days is diagnosed with primary herpes labialis and asks about using a topical medication. What will the provider tell this patient?
Topical medications can have an impact on pain and discomfort. A patient is taking a sulfonamide antibiotic and develops a rash that begins peeling. Which type of rash is suspected? Stevens-Johnson A child is brought to a clinic with a sudden onset of rash after taking an antibiotic for 2 days. The provider notes all over wheals with pruritis, which the parent reports seem to come and go. Which action is correct? Admit the child to the hospital for treatment and observation Which types of medications are associated with urticarial type rashes? Select all that apply. Erythromycin NSAIDs Penicillins A patient who has chronically dry skin who has been using emollients and moisturizers reports an uneven diamond pattern and redness on the lower legs and arms. What will the provider recommend? Referral to a dermatologist
Which medications may be useful in treating tension-type headache? Select all that apply. Antiemetics Muscle relaxants NSAIDs A provider suspects that a patient has bacterial meningitis. When should antibiotics be given? Prior to obtaining a CT scan or lumbar puncture A patient is brought to the emergency department with fever, lethargy, and headache without meningeal signs. The examination reveals hypotension and lethargy and the examiner notes petechiae on the patient's trunk. What do these findings indicate? A poor prognosis A patient reports two episodes of visual disturbances and eye pain that lasted 1 to 2 days each about 2 months apart. Which diagnostic testing will the provider order initially? Magnetic resonance imaging A patient diagnosed with multiple sclerosis and begins disease modulating therapy drugs. As part of the counseling about this therapy, the provider will tell the patient that this regimen will
reduce the exacerbation rate. A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency department with a seizure which has persisted for15 minutes and which immediately followed another 15 minute seizure. What is the priority action for this patient? Administer lorazepam and monitor cardiorespiratory status A patient with a seizure disorder has seizures which begin with eye twitching and occasionally visual hallucinations. Which site in the brain is the seizure focus? Occipital Which drug is used to treat patients with focal epilepsy and complex partial seizures? Carbamazepine A patient reports paroxysms of burning, shock-like pain on both sides of the face usually triggered by chewing or talking. The provider suspects trigeminal neuralgia. Based on these presenting symptoms, what testing is indicated? Magnetic resonance imaging A patient with trigeminal neuralgia has tried several medication regimens to control pain without success. What is the next step in management for this condition?
Select all that apply. Selective serotonin reuptake inhibitors Serotonin-norepinephrine reuptake inhibitors Tricyclic antidepressants A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines that these symptoms occur in relation to many events and concerns. What other things will the provider question this patient about? Headaches and bowel habits A patient is seen in clinic 2 weeks after the death of a parent. The patient reports feelings of sadness and hopelessness and a feeling that the parent is still present, even to the point of hearing the parent's voice at times. What will the provider determine from these findings? These are normal grief responses. A college student is brought to clinic by a parent who is concerned about increasingly bizarre behavior and poor school performance. The provider notes difficulty engaging the patient in an organized conversation. The patient denies any concerns about behavior. What will the provider do initially to manage this patient's symptoms? Begin treatment with lithium or lamotrigine
A patient is seen frequently over a 9-month period with somatic complaints that are not related to physical disease. The primary provider notes that the patient has had a 15% weight loss in the previous 2 months and the patient reports difficulty sleeping. The spouse tells the provider that the patient seems tired all the time and is irritable with other family members. What will the provider do initially? Perform a suicide risk assessment A patient is brought to the emergency department who is experiencing disorientation, confusion, and fever. The patient describes visual and auditory hallucinations. The patient's spouse states that the patient had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended treatment? Benzodiazepines A college student is brought to the emergency department by a roommate who is concerned about symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects withdrawal from which substance? Opioids A 17-year-old male is brought to the clinic by a parent who is concerned that the patient has become more isolated and withdrawn and expresses suspicions that his teachers hate him and want him to fail. What will the provider tell this parent? The adolescent should be evaluated by a psychiatrist.
The practitioner is establishing a plan for routine health maintenance for a new female client who is 80 years old. The client has never smoked and has been in good health. What will the practitioner include in routine care for this patient? Pneumovax vaccine if not previously given Yearly influenza vaccine A previously healthy 30-year-old patient is brought to the emergency department with signs of stroke. Diagnostic testing determines an ongoing ischemic cause. The patient's spouse reports that symptoms began approximately 2 hours prior to transport. What is the recommended treatment? Tissue plasminogen activator (tPA) administration An elderly patient is brought to the emergency department after being found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient's blood pressure is 220/190 mm Hg. What is the likely treatment for this patient? Neurosurgical consultation A patient exhibits visual field defect, ataxia, and dysarthria and complains of a mild headache. A family member reports that the symptoms began several hours prior. An examination reveals normal range of motion of the neck. What type of cerebrovascular event is most likely?
Ischemic stroke A patient with dementia experiences agitation and visual hallucinations and is given haloperidol with a subsequent worsening of symptoms. Based on this response, what is the likely cause of this patient's symptoms? Lewy body dementia A patient with Alzheimer's disease (AD) is taking donepezil to treat cognitive symptoms. The patient's son reports noting increased social withdrawal and sleep impairment. What is the initial step to manage these symptoms? Encourage activity and exercise An elderly patient has symptoms of depression and the patient's daughter asks about possible Alzheimer's disease since there is a family history of this disease. A screening evaluation shows no memory loss. What is the initial step in managing this patient? Prescribe a trial of an antidepressant medication Which are common hyperkinetic movement disorders? Dystonia
A patient who is near death is exhibiting signs of agitation, anxiety, and intractable pain. When discussing palliative sedation with this patient's family, what will be discussed? The fact that this is an intervention of last resort The need for informed consent from the patient and family The possibility that this measure may hasten death When should palliative care be initiated by a primary care provider? As part of routine health maintenance When using the "Five Wishes" approach to documenting patient preferences for end-of-life care, the provider will document which types of preferences? How much information to give various family members The level of sedation versus alertness the patient desires The people designated to make care decisions for the patient A patient being treated for cancer has had chemotherapy within the past two weeks and comes to the primary care clinic with a fever of 38.5° C. What is the initial action? Obtain a STAT CBC with differential
What is the most important role of the primary care provider in cancer management? Counseling about healthy practices to reduce risk factors An oncology specialist recommends placement of radioactive isotopes in capsules near a patient's tumor. What is this form of radiation therapy called? Brachytherapy Which chemotherapeutic agent classes are S-phase specific agents? Fluorouracil Mercaptopurine Methotrexate What is the purpose of radiation treatment prior to surgical resection of a tumor? To debulk the tumor mass A patient who has non-Hodgkin's lymphoma reports a dull, aching back pain in the thoracic region for several weeks along with difficulty walking. The provider notes an ataxic gait. What is the immediate treatment for this condition?
A female patient is diagnosed with unknown primary carcinoma (UPC) after a metastatic squamous cell carcinoma is found. She asks the provider for an estimate about survival. What is the median survival rate for this type of UPC? 24 months A woman has carcinomas confined to axillary nodes. A mammogram is normal. What is the next step in managing this patient? Evaluate HER-2 and estrogen and progesterone receptors A patient with cancer is expected to require long-term pain medication to manage cancer pain. Which agent will be best for this patient? Morphine A patient with breast cancer has been symptom-free for 6 months and reports a new onset of lower back pain rated as an 8 on a 1 to 10 pain rating scale to the primary provider. What is most important when evaluating this patient's pain? Obtaining an MRI of the spinal cord A patient with cancer is reluctant to take an opioid agonist medication because of the side effects. What will the primary care provider recommend? Taking a stool softener with the opioid
A patient has rapid weight gain, amenorrhea without pregnancy, and mild hypertension. Once confirmatory tests are performed, what is a possible treatment for this patient? Pituitary tumor resection A patient has new-onset hypertension with a systolic blood pressure of 180 mm Hg. Which test will the provider order to diagnose this patient? Fractionated metanephrine levels A patient has unexplained weight loss and the provider notes increased skin pigmentation on light-exposed skin folds along with darkened palmar creases. Which laboratory tests will the provider order? Serum ACTH Serum electrolytes TB skin testing A young adult woman is unable to conceive after trying to get pregnant for over 6 months. The woman reports having had irregular periods since the onset of menarche. The provider notes that the woman is overweight, has acanthosis nigricans, and an excess hair distribution. What does the provider suspect as the most likely primary cause of these symptoms? Polycystic ovarian syndrome
A patient with normal renal function has a potassium level of 6.0 mEq/L. Which underlying cause is possible in this patient? Adrenocortical deficiency A hospitalized patient with renal failure is accidently given parenteral potassium and has a potassium level of 7.0 mEq/L. An ECG reveals a normal QRS interval. What is the initial recommended treatment for this patient? Insulin and glucose infusion A patient has a serum potassium level of 3 mEq/L and a normal blood pressure. Which test should be performed initially to assist with the differential diagnosis? Serum bicarbonate A patient has euvolemic hyponatremia secondary to chronic syndrome of inappropriate antidiuretic hormone (SIADH) and is hospitalized for fluid replacement. When preparing to discharge the patient home, what will be included in teaching? Limiting fluids to 500 mL/day for several days
An elderly patient who is taking a thiazide diuretic has been ill with nausea and vomiting and is brought to the emergency department for evaluation. An assessment reveals oliguria, hypotension, and tachycardia and serum sodium is 118 mEq/L. What is the treatment? Emergency volume repletion with 3% NaCl. A high school athlete is brought to the emergency department after collapsing during outdoor practice on a hot day. The patient is weak, irritable, and confused. Serum sodium is 152 mEq/L and has dry mucous membranes and tachycardia. What is the initial approach to rehydration in this patient? Intravenous fluid resuscitation with an isotonic solution A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0. mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for this patient? Annual monitoring of calcium, creatinine, and bone density Which laboratory values representing parathyroid hormone (PTH) and serum calcium are consistent with a diagnosis of primary hyperparathyroidism? Inappropriate secretion of PTH along with hypercalcemia Which findings are symptoms of hyperparathyroidism? Cognitive impairment Left ventricular hypertrophy
