Sample Test Questions

First name:    Last name:

1. During an annual health visit, a 15-year-old female patient is found to have grown 5 in (12.7 cm) over the past year. She has not reached menarche. Her mother is concerned because the patient's sister reached menarche at age 11 and the mother reached menarche at age 12. Examination reveals that the patient's breasts are enlarged, with the areolae forming a mound above the general contour of each breast, and that the left breast is larger than the right. Axillary hair is absent and the pubic hair is dark, coarse, curly, dense, and similar in pattern to that of an adult female. These findings are consistent with a diagnosis of:

2. A pale, thin 54-year-old male patient reports a two-month history of numbness in his feet. Past medical history includes hypertension and a subtotal gastrectomy. An examination reveals a decreased vibratory sensation and position sense. Blood tests indicate a hematocrit of 27%, mean corpuscular volume of 105 fL, mean  corpuscular hemoglobin of 45 pg, and reticulocytes of 1.5%. The diagnosis is:

3. Upon referral from a gynecologist, an adult nurse practitioner evaluates an 89-year-old female nursing home resident for vaginal bleeding. The patient has a history of occasional periods of confusion and memory loss. The gynecologist recommended dilation and curettage and the patient consented to the procedure after the gynecologist answered her questions, but the patient's daughter protests. The nurse practitioner's ethical duty is to support the:

4. A 16-year-old patient has been diagnosed with mononucleosis and has a positive throat culture for group Alpha-hemolytic streptococcal infection. The medication of choice for this patient is:

5. A 70-year-old patient reports fatigue and a nonproductive cough with pain on inspiration and expiration. The patient denies a sore throat, fever, nasal congestion, or postnasal drip. Examination reveals a well-developed patient in no acute distress who is afebrile and has respirations of 32 breaths/min. The patient's lungs have diminished breath sounds. The heart rate is 70 beats/min, regular with no murmur. There is no edema of the extremities. An adult nurse practitioner orders:

6. Before placing a patient with onychomycosis on a pulsed dose of itraconazole (Sporanox), which laboratory values does an adult nurse practitioner obtain?

7. An adult nurse practitioner is educating a female patient about her newly diagnosed phobia. The nurse practitioner explains that phobias differ from other anxiety disorders in that phobias:

8. A 70-year-old female patient visits the adult nurse practitioner for a yearly evaluation. Which physical examination finding receives the highest priority for immediate treatment?

9. A 30-year-old female patient has a two-week history of nausea, vomiting, decreased weight, and abdominal pain, and a long-term history of multiple sexual partners. The patient's physical examination reveals abdominal tenderness, and icteric sclerae and skin. Which laboratory test rules out active hepatitis B?

10. A 78-year-old male patient comes to the ambulatory care clinic and reports an inability to void. The adult nurse practitioner has difficulty inserting a urinary catheter due to an obstruction. The nurse practitioner's action is to:

11. A patient comes to the clinic with reports of acute pain and loss of vision in the right eye. The adult nurse practitioner informs the patient that these symptoms require:

12. A 45-year-old patient with diabetes comes to the clinic for an annual appointment. The patient declines a parenteral influenza vaccination because a friend "came down with the flu after receiving the vaccination."  The adult nurse practitioner explains that the vaccination is:

13. An institutional review board rejects an adult nurse practitioner's research proposal on the grounds that the:

14. A patient informs an adult nurse practitioner, "I want to stop smoking." The nurse practitioner responds:

15. An adult nurse practitioner is responsible for billing codes that are selected and submitted to third party payors when:

16. Many patients view illness as a distortion in the balance of some aspect of their lives, and believe that folk medicine can remedy this. When encountering such beliefs, an adult nurse practitioner's appropriate action is to:

17. An adult nurse practitioner is designing a research study to investigate the efficacy of a patient education tool for adults with low literacy levels. Which action reflects the nurse's inclusion of ethical principles in the research plan?

18. An adult nurse practitioner evaluates a patient who has been a victim of domestic violence. After the office visit, law enforcement authorities contact the nurse practitioner, requesting information regarding any visible injuries observed during the visit. The nurse practitioner's response is to:

19. An adult nurse practitioner witnesses a coworker's injury due to a chemical spill. To which regulatory agency is this incident reported?

20. When interviewing a female adolescent patient about her sexual history, an adult nurse practitioner's most effective strategy is to:

21. The practical application of findings from a set of studies is known as:

22. An adult nurse practitioner is encouraging an older adult patient to reminisce about successful life accomplishments. Which theoretical framework is the nurse practitioner using?

23. An adult nurse practitioner evaluates a new patient, an African American with hypertension who has been taking lisinopril (Prinivil). To optimize the patient's response, a more effective pharmacological treatment is:

24. Initial measures to prevent deformity and maintain function for the knee during an acute inflammatory reaction secondary to injury include:

25. A 34-year-old truck driver reports a sharp pain in the lower back that worsens with ambulation. The symptoms began after a strenuous three-day driving trip. During an examination, the patient has difficulty walking on the heels and shows weakness in the extensors of the big toes. The initial differential diagnosis is: