NP Certification Q&A

A 28-year-old woman with a longstanding history of injection drug use presents with a 10-day history of malaise, nausea, and fatigue, and a two day “yellow eyes”.  Physical exam reveals scleral icterus and mild hepatomegaly with right upper quadrant tenderness. Considering the possibility of acute hepatitis B in the differential, the NP anticipates laboratory results will include.  A. The presence...

A 22-year-old woman presents for follow-up after a recent clinic, requested STI screening. Testing for Chlamydia trachomatis was positive. She states, “I am really surprised, I feel fine.”  Her current medications include combined oral contraceptive and her LMP was about 10 days ago, with appropriate timing and a  3 day light flow. The NP considers which of the following is the best option? A. Giv...

A 62-year-old woman with T2DM presents 2 days after noticing a “bug bite” on her left lower leg, stating, “I am not sure what bit me.” During this time, the area has increased in size and she reports discomfort in the region.  Examination reveals a tender warm, red, erythematous area with poorly demarcated borders, approximately 15 cm at its widest diameter on the anterior lower leg.  Calf circumf...

The NP sees a well, 18-month-old with a two-day history of clear nasal discharge, dry cough, intermittent fever to 101.4 or 38.5C, and mild crankiness. She's up to date with all recommended vaccination. Parents report everyone at home has this cold. Testing for RSV, COVID-19, influenza are all negative. She is alert, age appropriately resists the exam, which is consistent with viral URI.  Her...

The NP is seeing a 35 year-old well woman for a health promotion and physical exam woman. She has not complaints, is a nonsmoker, a light social drinker with 1-2 glasses of wine per month, and exercises about 30 mins 5 days a week. Her BMI is 22 and vital signs are unremarkable with BP= 110/70. Which of the following is an anticipated finding on her funduscopic exam? A. Retinal arteries wider than...

A healthy 1 year old, accompanied by his mother, is in for a well child visit. He is due to receive routine immunizations for a child his age. His mother mentions that she is about 6 weeks pregnant and read that, “I know he should get the chickenpox and German measles vaccines today. Since I am pregnant, is this safe?” The NP considers the following: A. Neither vaccine contain live virus and both...

A 78 year-old woman with well-controlled hypertension and dyslipidemia presents with a chief complaint of a many month history of pain, described as achiness, and stiffness in the joints both hands, particularly towards the end of the day. A part-time seamstress, she reports this discomfort is worse on work days.  She denies redness or heat in the affected regions and has no systemic complaints. P...

A 67-year-old man who is diagnosed with acute bacterial prostatitis presents with a chief complaint of a one-week history of constant perineal pain, arthralgia, irritative voiding symptoms, and intermittent fever. Which of the following is most consistent with anticipated findings on prostatic digital rectal exam (DRE) with this condition? A. An enlarged prostate with obliterated median sulcus B....

Which of the following is most likely to be reported as part of the HPI in a woman presenting with bacterial vaginosis? A. A 19-year-old woman with a 3-day history of vaginal and perineal itch, clumping white vaginal discharge that has a slight “musty” odor. B. A 24-year-old woman with a 1-week history of mild perineal irritation, thin, grey-green vaginal discharge with a strong “fishy” odor. C. A...

A 67-year-old man has been recently diagnosed with HTN, dyslipidemia and T2DM. As part of his medication treatment plan, he agrees to start statin therapy. The NP appreciates that which of the following laboratory tests should be conducted about 4-12 weeks after starting statin therapy? A. AST and ALT B. CK and potassium C. Lipid profile D. CBC with WBC differential and platelet count --- YouTube:...

A 65-year-old woman has hypertension, dyslipidemia, type 2 diabetes, a 50 pack-year history of cigarette smoking, currently smoking ½ PPD,  and stage 3B chronic kidney disease (CKD)  (GFR = 37 mL/min/1.73 m2). She is not currently taking any dyslipidemia therapy and her LDL= 140 mg/dL. Which of the following represents the most appropriate pharmacologic intervention for treatment of dyslipidemia?...

Leonardo is a healthy 4- month-old who was born at 40-weeks gestation is in the office for a well child visit. His parents voice no concerns and state, “He is a very happy baby who loves to eat and is a good sleeper.” Which of the following is an anticipated normative developmental finding on an infant of this age? A. Sitting without support   B. Minimal to no Moro reflex noted C. Rolling over tum...

A 28-year-old woman G2P1LC1AB0, currently 22-weeks pregnant, presents with a 3-day history of urinary frequency and dysuria.  She is in no acute distress, without fever or vaginal discharge, reports “The baby is really moving around a lot” and denies GI symptoms. Fundal height is consistent with gestational age and FHT= 140 BPM and regular. UA dip in office is positive for leukocyte esterase and n...

Robert has recently graduated from a NP program. During a job interview for an organization that has clinical sites in multiple states, he is asked questions about NP practice issues. Which of the following is accurate? A.   Once I am nationally certified, I am also licensed to practice as an NP. B. Once I am a certified NP and licensed to practice in one state, I will be able to practice in every...

A 45-year-old woman presents for a sick visit with a chief complaint of 2–3-day sudden onset right elbow swelling with pain, stating, “I’ve never had pain like this. It looks like I have a swollen ball hanging from my elbow”.  She denies recent or remote injury to the area, fever, pain in other joints or skin lesions, and does report recently spending an extensive period of time on her computer du...

A 37-year-old adult was diagnosed with dyspepsia with documented H. pylori infection. An appropriate course of antimicrobial and proton pump inhibitor (PPI) therapy was prescribed and completed approximately 4 weeks ago. The patient states that the presenting symptoms have resolved and, “My stomach feels much better.” Which of the following is the most appropriate next step in care? A.  Serologic...

Sarah is a 75 year-old woman with a 40 year history of HTN and a 30 year history of T2DM and dyslipidemia who was recently diagnosed with stage 4 chronic kidney disease (CKD). Given this history, which of the following hemograms would be expected?  A. Hb = 9.7 g/dL (12 to 14 g/dL); MCV = 69 fL (80 to 96 fL); RDW=18% (11.5-15%) B. Hb = 7.2 g/dL (12 to 14 g/dL); MCV = 122 fL (80 to 96 fL); RDW= 18.1...

Which of the following is a MEC Category 4 (use represents unacceptable health risk) to the use of a CHC (combined hormonal contraception method such as combined oral contraception [COC])? A.  Mother with a history of breast cancer. B. Personal history of hepatitis A at age 10 years. C. Presence of factor V Leiden mutation. D. Cigarette smoking one pack per day in a 22-year-old. --- YouTube: https...

You see a  17-year-old  woman with a long-standing history  of eczema and allergic rhinitis. Today she presents with worsening symptoms of skin lesions with itch for the past 2 months, now affecting the antecubital fossa of both arms, stating, “I get like this every winter but I am much better during warm weather. “  She is otherwise healthy. The most important aspects of skin care for this scenar...

A 72-year-old woman with severe COPD, who uses an inhaled LAMA/ LAMA daily on a set schedule and SABA via MDI as needed for symptom relief, presents with a 4-day history of URI symptoms, starting with sore throat and clear nasal discharge, without fever. She denies N, V, or other GI upset. She now reports a 2-day history of increasing shortness of breath and production of clear to white sputum. Sa...

The NP is seeing a 65-year-old woman who is a former smoker, having quit at age 40, with a 20 pack-year cigarette smoking history, and has been diagnosed with community-acquired pneumonia (CAP). Which of the following is most often noted CAP finding in an adult who is deemed to be appropriate for outpatient treatment?  A. Pleuritic chest pain B. Dyspnea C. Purulent sputum production D. Cough --- Y...

A 27-year-old, otherwise well, woman complains of recurrent headache that occurs every 1‒2 weeks and lasts up to 24 hours. During headache, she reports sudden onset of unilateral pulsating pain, nearly always on the left side that is accompanied by photophobia, phonophobia and mild nausea without vomiting. Her first headache occurred when she was approximately 12-years-old.  Her neurological exam...

When advising a patient on the use of emergency contraception (EC) with levonorgestrel (LNG), which of the following is correct? A. If pregnancy does occur post LNG EC use, a teratogenic pattern in the offspring has been noted B. EC LNG must be used within 12 hours after unprotected heterosexual vaginal intercourse to provide EC benefit.  C. LNG EC’s use is limited due to a number of common contra...

The NP is caring for a 68 year-old man with a 20 year-history of  type 2 DM, HTN, dyslipidaemia, obesity (BMI=32 kg/m2) stage 3a CKD who is currently taking all of the following medications at optimized doses and with adherence, ACEI, thiazide diuretic, statin, and metformin. His current A1c= 8.2%. (NL= <5-6%)  and states he is feeling well. Which of the following should be considered as next s...

In which of the following situations is parental consent usually needed prior to treatment?  A. A 16-year-old requesting information about contraception.  B. A 17-year-old who wants help with smoking cessation.  C.A 16-year-old requesting treatment for acne vulgaris.  D. An 18-year-old who requests treatment for a sexually transmitted infection. --- YouTube: https://www.youtube.com/watch?v=4o47mBH...