NP Certification Q&A

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...

The legal authority of a nurse practitioner’s scope of practice is defined by: A. The organization that grants NP certification.  B. The NP’s employer.  C. The law of the state where the NP practices.     D. Federal law. --- YouTube: https://www.youtube.com/watch?v=1hF-FgAfKdw&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=12 Visit fhea.com to learn more!

The nurse practitioner is seeing a 24-year-old man in follow-up visit.  Three weeks ago, he was diagnosed with allergic rhinitis,  reporting that, “ for years, every spring when the pollen count is high, I get a runny, stuffy nose, and itchy throat”.  He started on a regimen of daily use of an intranasal corticosteroid as a controller medication with PRN use of an oral second-generation antihistam...

A 34-year-old woman presents with uncomplicated UTI. Her last menstrual period ended approximately 5 days ago and has a history of bilateral tubal ligation approximately 5 years ago. She is otherwise healthy, has not received a systemic antimicrobial in the past year, denies drug allergies, and is not taking any medications. Per local antibiogram,  E. coli resistance rate to TMP/SMX is about 25%....

In evaluating a 66-year-old man with dilated cardiomyopathy and heart failure, the NP notes a grade 3/6 medium-pitched blowing systolic murmur that radiates to the axillae. What do these findings most likely represent? A.Innocent murmur B. Mitral stenosis C. Aortic regurgitation D. Mitral regurgitation --- YouTube: https://www.youtube.com/watch?v=b9XlXNKk04U&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H...

In treating a 26-year-old man with panic disorder who is otherwise healthy, you consider prescribing: A. Bupropion. B. Alprazolam. C. Citalopram D. Risperidone --- YouTube: https://www.youtube.com/watch?v=dDYv02H0iDI&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=8 Visit fhea.com to learn more!

Which of the following is a most often noted in a 65-year-old woman with osteoarthritis? A. Anemia of chronic disease is often noted.  B. Usually presents as a systemic polyarthritis. C. Constitutional signs and symptoms, including fatigue and unintended weight loss are reported  D. Typically impacts weight-bearing joints, particularly in early disease --- YouTube: https://www.youtube.com/watch?v=...

A 55-year-old woman with recently diagnosed hypertension was started on a standard dose of or a thiazide diuretic daily 6 weeks ago. Today her blood pressure is 128/78 mm Hg and the patient is feeling well, and clinical exam fails to reveal abnormal heart sounds or hypertensive retinopathy.  The appropriate action at this time would be to? A. Consider switching her HTN medication to a calcium chan...

A  45-year-old woman with no chronic health problems presents a 6-month history increasing fatigue despite adequate opportunity for rest , worsening dry skin and increased menstrual flow volume. In analyzing the laboratory data below, which is most consistent with the diagnosis of hypothyroidism?  A. TSH <0.15 mIU/L (0.4–4.0 mIU/L), free T4=79 pmol/L (10–27 pmol/L) B. TSH=8.9 mIU/L (0.4–4.0 mIU...

Saundra is a 72-year-old with hypertension who is on an appropriate dose of an ACE inhibitor with adherence. Today’s BP= 152/96 and is without HTN-related complaint.  Physical exam is unremarkable. She has a history of well-controlled asthma and is using ICS/LABA therapy.  Due to osteoarthritis, she reports, “I get up slowly. Sometimes I do not get the bathroom on time and I lose my urine control....

Josh is a well 16-year-old male who presents with a reporting a 4-day history of moderate left-sided otalgia with intermittent fever.  Clinical assessment is consistent with acute otitis media (AOM).  No drug allergy or recent (within the past month) antimicrobial use is reported.  Which of the following represents the most appropriate first-line antimicrobial therapy? A. Oral moxifloxacin B. Oral...

A 35-year-old w presents complaining of a 15+ year history of recurrent cramping abdominal pain that is often relieved with defecation that occurs intermittently. Symptom onset is often accompanied by bloating and a change in stool frequency and form, particularly when “I eat certain foods.” She denies bloody or tarry stools, nausea, vomiting or fever. The NP notes the patient’s weight is stable,...

The NP sees a 34-year-old woman with a chief complaint of 6-month history of increasing fatigue despite adequate opportunity to sleep and rest. Laboratory results reveal a microcytic, hypochromic anemia with elevated RDW. You expect to find which of the following upon review of the patient’s health history? A. Report that she has been eaten a plant-based diet since age 18 B. History of prolonged m...