Expiration Date: December 31, 2008. No CE contact hours (CH) will be given after this date.
This continuing education module should be taken ONLY by those who have purchased the Family Nurse Practitioner Review and Resource Manual, 2nd Ed. During the process of purchasing this CE module, you will be asked to input the proof of purchase code which can be obtained by sending an e-mail to revmanuals@ana.org.
The actual questions that will be on the test have been posted below.
When you purchase the CE module, you will be issued a password which will allow you to access all CE modules purchased on the NursingWorld Web site. This password is NOT to be confused with the proof of purchase code you received when you purchased the manual. It is important that you remember this password, as you MUST use it if you wish to log out of the system and return at a later time to take the test or to print duplicates of your certificate of completion.
IMPORTANT NOTE: The test for Contact Hours for Family Nurse Practitioner Review and Resource Manual contains 23 questions. You may find that you are not able to complete the entire test in one sitting. If this is the case, simply click on "Grade My Test" at the bottom of the test page even though you have not yet completed the test. This will allow the system to store your test for your return visit.
When you wish to return, click on "Log Back In" from the CE home page menu and input the CE password you were issued when you first registered for ANA's online CE. Again, do not input the purchse code you were issued as proof of purchase of the manual. Once you are logged back into the system, you will see a list of the ISMs you have completed and ones that are incomplete. Click on "Take Test" next to any incomplete ISM and you will be told how many questions you have completed and how many are left to complete.
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Test Questions
1. Which puts a patient at a greater risk for suicide?
- a. Prior suicide attempt(s) in the extended family
b. Specific plan
c. Irritable feelings
d. Abuse in the home
2. Which statement about the Duvall theory of the stages in family development is true?
- a. The stages cannot overlap
b. The stages are based on the age and school placement of the firstborn child
c. There are four stages
d. Marriage is strongest during the fourth stage.
3. Why is it important for pregnant women to maintain adequate folic acid intake?
- a. To prevent hemorrhagic disease in the newborn
b. To prevent pernicious anemia in the pregnant woman
c. To prevent neural tube defects in the newborn
d. To prevent rickets in the pregnant woman
4. What is the appropriate management of a 27-year-old patient just diagnosed with Lyme disease?
- a. Sulfamethoxazole and trimethoprim (Bactrim) 400 mg bid x 14 - 21 days
b. Amoxicillin (Amoxil) 25 - 50 mg/kg/d
c. Doxycycline (Vibramycin) 100 mg bid x 14 - 21 days
d. Cephalexin (Keflex) 100 mg/kg/d
5. A 75-year-old patient complains of malaise and dysesthesia and has vesicular eruptions on one side of the back. There is itching, pain, and tingling in the area of the rash. The client's oral temperature is 1010F (38.30 C). The most likely diagnosis is:
- a. Herpes zoster.
b. Herpes simplex virus infection.
c. Impetigo.
d. An allergic reaction.
6. The most important characteristic of acute otitis media that distinguishes it from otitis media with effusion is the presence of:
- a. hearing loss with ear popping and crackling.
b. otalgia, otorrhea, and decreased mobility of tympanic membrane.
c. temporomandibular joint pain.
d. eustachian tube obstruction.
7. A 45-year-old nonsmoker who has never been hospitalized develops a sudden onset of fever and chills, productive cough, chest discomfort, and severe fatigue. The physical exam shows VS 101.40F (38.50C); pulse 116; respirations 34. Lungs have rhonchi and rales in the LLL. The most likely causative organism is:
- a. Streptococcus pneumoniae.
b. Staphylococcus aureus.
c. Moraxella catarrhalis.
d. Influenza A.
8. How does the family nurse practitioner manage a 58-year-old patient who has a blood pressure reading of 162/90 mm Hg?
- a. Have the client return for successive blood pressure checks
b. Have the client return for a total of three successive blood pressure checks and reduce sodium intake
c. Initiate treatment with 25 mg of hydrochlorothiazide (Microzide) daily
d. Plan to recheck the client in 3 months
9. What is the classic physical finding that determines a diagnosis of pyloric stenosis in an infant?
- a. Murphy sign
b. McBurney point
c. Psoas sign
d. Palpable olive
10. Examination of a 46-year-old perimenopausal woman confirms a Bartholin cyst on the right labia. She is currently asymptomatic. The management plan for this patient includes:
- a. culture for STDs and begin amoxicillin/clavulanate (Augmentin).
b. warm soaks to promote drainage and follow up as needed.
c. incision and drainage in office with patient's consent.
d. referral to a gynecologist for excision to rule out carcinoma.
11. Evaluation of a 6-year-old male with an asymptomatic, firm pear-shaped sac behind the testicle includes:
- a. fluid aspiration for culture and sensitivity.
b. transillumination.
c. doppler ultrasound.
d. immediate referral, if located on the right side.
12. A patient asks on her first prenatal visit, if it will be necessary to have a Cesarean delivery since she has Herpes Simplex, type 2 infection. The FNP's most appropriate response is:
- a. Yes, it is safest for the baby to prevent neonatal infection.
b. No, perinatal transmission is likely before delivery.
c. Cesarean delivery will be considered based on the number of outbreaks during
pregnancy and amount of pain the mother is in.
d. Cesarean delivery is recommended when active lesions are visible at the onset of
labor.
13. Which maneuver is performed to identify meniscal damage?
- a. Lachman test
b. McMurray test
c. Anterior drawer test
d. Posterior drawer test
14. Trigeminal neuralgia is caused by:
- a. compression of the optic nerve.
b. compression of the 5th cranial nerve.
c. herniated disk.
d. Bell palsy.
15. A patient comes to the clinic requesting a pregnancy test. The test is positive. Besides referral for obstetrical care, what dietary supplements does the family nurse practitioner recommend at this time?
- a. None, as it is very early in pregnancy
b. Prenatal vitamin with folic acid
c. Vitamin C
d. Vitamin E
16. A 4-year-old boy presents with failure to grow. When reviewing his growth chart, he was normal birthweight and size, but he has remained consistently 2 standard deviations below normal on the growth chart. X-ray shows a delay in bone growth. The most likely diagnosis is:
- a. Turner syndrome.
b. constitutional delay in growth.
c. genetic short stature.
d. Klinefelter syndrome.
17. A 12-year-old boy is brought in by his parents for increasing behavior problems in school and in the neighborhood. Which of the following descriptions would prompt your referral for a possible conduct disorder?
- a. Disregards the rights of others
b. Shows remorse for misconduct
c. Easily distracted, forgetful, does not complete tasks
d. Mood swings, agitation, restlessness
18. A 5-year-old boy comes to the clinic with his mother who is concerned about his bedwetting. He has been dry since age three and now he is wetting the bed almost nightly for the past month, when his mother returned to work for the first time since his birth. The physical exam is normal and the urinalysis is negative, although he is fearful and crying when you examine him. To help determine the cause of bedwetting in the context of family function, the FNP:
- a. assesses the boundaries within the family system.
b. assesses the change in the mother's role functions since returning to work.
c. identifies how the family members communicate about the child's bedwetting.
d. take a family genogram to determine if bedwetting is a family problem.
19. Which is a major symptom of rheumatic fever according to the Jones criteria?
- a. Fever
b. Subcutaneous nodes
c. Chest pain
d. Elevated ESR
20. A 28-year-old male who complains of a maculopapular scaling rash for two days is diagnosed with Pityriasis Rosea. During the history, he reveals that he had a large single bright red patch that preceded this rash eruption by about 2 weeks. Where does the location of the current rash most likely present and what is the origin?
- a. Across the entire body; is metabolic in origin
b. Across the trunk; most likely contact in origin
c. Across the trunk; most likely infectious in origin
d. Across the entire body; most likely infectious in origin
21. A 10 year-old male is brought in by his mother for evaluation of frequent "colds." It seems he has had one almost every month x 2 years and has been sent home from school today due to yellowish nasal mucus. He is active, afebrile with watery rhinorrhea. Turbinates are pale and boggy, TMs clear, oropharynx clear and lungs clear. The most likely diagnosis is:
- a. acute bacterial sinusitis.
b. recurrent viral URIs.
c. allergic rhinitis.
d. vasomotor rhinitis.
22. A PPD result on a 7-year-old who has a parent with suspected TB is 7mm induration. The treatment plan for this patient is to:
- a. counsel the family about TB and repeat PPD in 3 months.
b. order a CXR and begin medication if CXR is suggestive of pulmonary disease.
c. order a CXR and begin treatment with INH.
d. begin INH therapy.
23. A 70 year-old man presents with anemia, recent weight loss and heme positive stools. He has no GI complaints. The diagnosis until proven other wise is:
- a. ulcerative colitis.
b. peptic ulcer disease.
c. Hemorrhoids.
d. colon cancer.
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