NR 509 Final Exam

A 35-year-old female with a history of migraines presents to the clinic with
worsening symptoms for the past few weeks. She reports waking up at night with
headaches and nausea. Her only medication history is oral contraceptive pills
(OCPs). Otherwise, she states she is healthy. Which of the following actions if taken
by the NP is the best next step?
Take a further history and perform a very careful neurological exam
A grandmother is accompanying her 9-year-old granddaughter during a routine
physical examination. She asks you privately if her granddaughter has started
puberty yet. During the examination, the NP notes asymmetric projection of the
areola and nipple of the right chest to form a secondary mound above the level of
the breast. The left breast is underdeveloped. These assessment findings are
consistent with which Tanner Stage of development?
IV
Primary prevention is defined as which of the following?
Interventions designed to prevent disease
Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which
of the following statements is true about screening for breast cancer in average-risk
women?
Mammography is recommended every 2 years for women aged 50-74 with
insufficient evidence for screening women over the age of 75.
Which of the following statements is true regarding recommendations by the eighth
Joint National Committee (JNC8) for adults aged 60 and older? Select all that apply.
Target blood pressure should be results in SBP <140 and is “well tolerated and without adverse effects to health or
quality of live, treatment does not need to be adjusted.”
In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear
optimal for notable reductions in stroke, cardiovascular events, and all-cause
mortality.
Which of the following is a useful strategy when examining young children between
the ages of 1 and 4?
Have the parent facilitate the exam (e.g., removing clothes, holding the child on
lap).
The NP is completing the review of systems on a 4-month-old female during a
routine encounter. Which statement from the parent may indicate a cardiac problem
in the infant and require a more thorough subjective history?
“It often takes the baby more than 30 minutes to finish a bottle.”
A 16-year-old male presents to the clinic with a history of a congenital right upper
eyelid drooping as represented in this image. He has no complaints and denies
injury or trauma. Which cranial nerve (CN) is involved in this condition?
Patient with eyelid drooping
CNIII
Which cranial nerve (CN) innervates the muscles of the pharynx and provides
sensory fibers to portions of the tympanic membrane, auditory canal, pharynx, and
the posterior third of the tongue?
CN IX
The NP should suspect injury to which cranial nerve (CN) if a patient presents with
complaints of photosensitivity and uneven pupils after being struck in the eye with a
baseball?
CNIII
Which of the following statements is true regarding risks and rapid recognition of
suspected stroke? Select all that apply
Obesity doubles the risk of stroke even without associated glucose intolerance
Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke
The combination of both receptive and expressive aphasia is a characteristic of
which type of speech disorder?
global aphasia
The NP is assessing a 42-year-old female who presents to the clinic with recurring
headaches. What is an effective question to ask the patient?
Do you have any aura prior to the headaches?