NPs Rosh 1 N6830 Exam 61 Questions with Verified Answers
What is the half life of aspirin? - CORRECT ANSWER 15-20 minutes
A 24-year-old woman
... [Show More] presents to the clinic complaining of worsening asthma symptoms. She states that she now has to use her albuterol inhaler three to four times per week and is awakened at night with symptoms about three times per month. The provider orders spirometry measurements, and her FEV1/FVC before a bronchodilator is 85%. Which of the following categories is this patient classified as in the stepwise progression of asthma? - CORRECT ANSWER Step 2, mild persistent
Which of the following environments would be the most appropriate for the initial dissemination of evidence-based literature? - CORRECT ANSWER Oral presentation at your hospital's journal club
When making clinical decisions about interventions based on evidence, which type of study is the highest level of evidence? - CORRECT ANSWER Systemic review
Who is responsible for regulating nurse practitioner prescribing authority? - CORRECT ANSWER State Board of Nursing
A 63-year-old man complains of fatigue, dyspnea on exertion, and swelling of his ankles and calves over the past two weeks. Which one of the following findings has the highest specificity for congestive heart failure? - CORRECT ANSWER Third heart sound
A 14-year-old girl presents to the clinic as a new patient for a well-child visit. Her mother reports that she fears her daughter has become sexually active. Which of the following would be an effective interviewing technique to utilize with this patient? - CORRECT ANSWER Ask the patient's mother to leave the room during your interview
What type of fears are common in children in their preschool years? - CORRECT ANSWER Fears of imaginary creatures, animals, and environmental elements like thunderstorms
A 68-year-old woman presents to the clinic for follow-up care of her diabetes. She was diagnosed with type 2 diabetes mellitus ten years ago. Despite regular appointments with her doctor and consistent compliance with her diabetes medications, she continues to resist the recommended lifestyle changes required to control her diabetes. In the last five years, she has developed diabetic neuropathy and nephropathy. She had an amputation below the left knee two years ago, and she continues to suffer from wounds in both of her legs. She was placed on hemodialysis eight months ago due to kidney failure. However, she states that she has no desire to change her diet, citing that "food is all I can really enjoy at this point, even though it's bad for my health". She is aware that the diabetes is slowly causing her body to shut down and will most likely kill her. She asks about her options for health care once she becomes too ill to make decisions, and she expresses interest in writing up an advance directive. Which of the following types of advance directives is recognized by state law in the United States? - CORRECT ANSWER Health Care Proxy
Which of the following should be included in a written report of suspected abuse in a pediatric patient? - CORRECT ANSWER The use of direct quotations from the child or parents
Clinicians who employ evidence-based disease management approaches for their patients realize that appraisal of the evidence requires the reader to evaluate the level of evidence as well as the number of studies available that have examined the specific clinical issue of concern. Which of the following research designs is considered the highest level of evidence when determining cause and effect relationships? - CORRECT ANSWER Randomized control trial
Which of the following can be a direct result caused by adolescents skipping meals? - CORRECT ANSWER Decreased school performance
The adult-gerontology acute care nurse practitioner is providing care to a patient that becomes agitated, expresses dissatisfaction with his healthcare team, and threatens to leave against medical advice. Which of the following therapeutic communication techniques is the most appropriate to implement? - CORRECT ANSWER Acknowledging or accepting
A 42-year-old man has been living in the United States for 6 years after migrating from Somalia. His medical history includes treatment for latent tuberculosis. He takes no routine medications and has no allergies. He presents to the clinic with complaints of nausea, stomach burning, bloating, and burping. He states he has had the issues for a "long time." He has not tried any medications for his reported symptoms. He does not smoke and denies use of alcohol. He denies weight loss, vomiting, diarrhea, or hematochezia. When providing culturally competent care, which of the following differential diagnoses is high on your list of concerns based on this patient's ethnicity? - CORRECT ANSWER Helicobacter pylori
Who is responsible for approving credentialing and privileging of the medical staff including NPs? - CORRECT ANSWER Hospital's governing body
When writing health policy, providing discussion of the consequences of action and inaction of a policy is an example of which of the following? - CORRECT ANSWER Discussing the impact
Which of the following is an essential ethical principle of biomedical research? - CORRECT ANSWER Beneficence
Which of the following activities for a 14-year-old child is considered a protective measure in preventing obesity? - CORRECT ANSWER Eating 1 - 2 family meals per week
Which of the following would best exemplify using patient- and family-centered care when creating a care plan for an adolescent patient? - CORRECT ANSWER Recognizing the strengths of the patient and his or her family and empowering them to use those strengths
A nurse practitioner-owned and run outpatient facility recently implemented an electronic medical record and electronic prescribing program. The nurse practitioner knows that the Medicare Modernization Act of 2003 supports the technology and encourages more utilization within America's health care system. Which Medicare plan supports the use of electronic prescribing? - CORRECT ANSWER Part D
A 12-month-old girl presents to the clinic with her mother for a well-child visit. You review her growth charts and note that the child has increased her height and weight since her 9-month check-up and is currently at the 60th percentile of weight for length. The child has two siblings, a sister age 3 and a brother age 5. You knock, open the door, and enter the exam room. The child is standing next to a chair and taking books away from her sister. When she sees you, she holds her arms up and attempts to climb onto her mother's lap. You do a review of systems by asking the mother about the child's play routine, dietary intake, sleep habits, gross motor skills, and language development. The mother reports that the child sleeps through the night, is eating table food, tries to do everything her siblings do, responds to her name, and can say "mama" and "dada." However, the mother remarks that she thought her other two children were talking more at this age and wonders if she should be concerned about autism. While completing a head-to-toe exam, the child makes eye contact when you speak to her and smiles appropriately. She resists the ear exam and cries as the mother assists you in completing the task. The child is easily soothed by the mother once you return to the computer. Which of the following responses is the most appropriate regarding the mother's concerns with the child developing autism? - CORRECT ANSWER I believe she is developing as expected for her age
A study finds that the negative predictive value of a new test for prostate cancer is 60%. Which of the following best explains this finding? - CORRECT ANSWER A total of 60% of patients who tested negative did not have prostate cancer
A 68-year-old Vietnamese speaking woman presents to the clinic for a problem visit. The office has arranged for an interpreter to attend this visit, but her daughter, who speaks Vietnamese and English proficiently, is also present. In a cross-cultural interview, which of the following guidelines should be used? - CORRECT ANSWER Confirm the patient understands the meaning of what you say
In the beginning of 2020, COVID-19 became a worldwide pandemic causing many countries to close borders, schools, public gatherings, and certain businesses. Public officials ordered health care facilities, pharmacies, and grocery stores to remain open to the public. What is the best way for outpatient health care facilities to reduce the spread of the COVID-19 infection? - CORRECT ANSWER Telemedicine
Which component of Medicare provides coverage for prescription drugs? - CORRECT ANSWER Part D
At an annual visit, a 28-year-old woman tells the nurse practitioner that she knows smoking is bad for her and is considering quitting. What stage of readiness to change is she exhibiting? - CORRECT ANSWER Contemplation
Which of the following is appropriate developmental anticipatory guidance to discuss with the parents of a 4-month-old girl at her wellness exam? - CORRECT ANSWER She will start rolling back to front by her 6-month wellness exam
A 33-year-old woman presents to discuss a personal health promotion plan the week before Halloween. She states she wants to lose weight. She has a body mass index (BMI) of 31 kg/m2 and is being treated for polycystic ovary syndrome (PCOS). She also has a family history of breast cancer (both her grandmother and mother have been treated for the condition). The patient is aware that it is best for her to eat a low-fat diet, but she explains, "I do want to lose weight, but I can't start my low-fat diet until after the holidays, because I love to eat Halloween candy and Christmas cookies." Her statement leads you to believe she is in which stage of the transtheoretical model? - CORRECT ANSWER Contemplation
Which of the following questions asks patients about their social stressors and supports? - CORRECT ANSWER Do you ever feel that you're not able to afford food, medications, or other medical expenses?
Research or clinical questions should be well focused and addressable, and they tend to be formed using the PICO method. What does PICO stand for? - CORRECT ANSWER Population, intervention, comparator, outcome
Conflict of interest occurs when the validity of study results are influenced by which of the following? - CORRECT ANSWER Personal relationships
A 42-year-old transgender woman presents to your office for a rash on the right lateral thorax. When addressing the patient and documenting the visit, which of the following pronouns would most likely be congruent with the patient's gender identity? - CORRECT ANSWER She, her, hers
A nurse practitioner is working in a family physician's office in a state that prohibits independent practice. According to the collaboration agreement with the physician, the nurse practitioner's primary role is to follow-up with patients, review labs, order any additional testing or interventions, and manage patient calls. A 67-year-old woman following up at her physicians' office for her recently diagnosed hypertension. The family nurse practitioner sees the patient to reevaluate her blood pressure since she started taking a new angiotensin-converting enzyme (ACE) inhibitor that was prescribed by the physician. The patient's blood pressure is 120/80 mm Hg, and no new interventions are implemented. How would the physician's office bill the patient's insurance company or Medicare? - CORRECT ANSWER Incident-to billing
The NP is responding to an increased incidence of extended-spectrum beta lactamase resistant Escherichia coli infections. The NP has evaluated evidence-based literature and developed a new protocol for the treatment of these infections. Implementation of this protocol is an example of which of the following steps of evidence-based practice? - CORRECT ANSWER Translation/Application
You are interpreting the results of a study evaluating risk for vancomycin-induced renal toxicity. The odds ratio for acute kidney injury in patients with a vancomycin level greater than 15 mg/l was 4.0. Which of the following is an accurate interpretation of this value? - CORRECT ANSWER Patient who received vancomycin were 4 times more likely to develop renal toxicity
You would like to conduct a study to correlate the results of a new rapid antigen testing kit with the standard culture for children with urinary tract infections. You plan to test all samples with a positive urinalysis and follow up the urine cultures within 48 hours. What method would best describe this study design? - CORRECT ANSWER Prospective cohort study
Which of the following describes emotional development typical in early adolescence? - CORRECT ANSWER Egocentricity
Which of the following state and federal programs is provided to assist people with limited income to afford medical care? - CORRECT ANSWER Medicaid
A family practice office is considering implementing a new electronic medical record. Which feature of the electronic medical record most likely validates the clinician's concerns for their adolescent patients' decision-making autonomy? - CORRECT ANSWER A feature that allows the patient/guardian access to their health information
A nurse practitioner is looking at research evidence to find an effective treatment plan for endometriosis. Which of the following research methods would present the strongest evidence? - CORRECT ANSWER A systematic review of randomized control studies
A nurse practitioner is working an evening shift at a local urgent care facility in a state that prohibits independent practice and requires a collaboration agreement with a physician. The nurse practitioner sees a 27-year-old man for a fall and a small right ulnar fracture. The nurse practitioner reviews the X-ray and determines the fracture needs to be placed in a cast, however, the nurse practitioner is new to practice and does not feel comfortable independently completing the task. The nurse practitioner reviews the case with the attending physician who applies the cast, while the nurse practitioner observes. What would be the most appropriate way for the urgent care to bill for this encounter? - CORRECT ANSWER Shared visit
A family nurse practitioner advises a 16-year-old girl to use sunscreen to prevent skin cancer. The girl responds that she sunbathes intentionally to get a tan and adds that she does not tan well with sunscreen. According to the health belief model, what chief construct does her statement demonstrate? - CORRECT ANSWER Perceived barriers
A nurse practitioner is working in an emergency department fast track and is seeing an adult man for a fall. The patient was working on his house and fell off a ladder, causing him to fracture his right radius. Orthopedics was consulted, and they placed a cast on his arm. The patient was requesting something stronger than acetaminophen for his 7/10 pain. The nurse practitioner understands how the opioid epidemic is affecting the community and wants to make sure it is safe to prescribe the patient something stronger. What is the best method for the nurse practitioner to utilize in determining if it is safe to prescribe a controlled substance? - CORRECT ANSWER Review prescription drug monitoring program
The extent to which an observation accurately measures what it is intended to measure describes what biostatistical term? - CORRECT ANSWER Validity
A pregnant woman and her husband present to the clinic for a new obstetrical visit at 10 weeks gestation. They report that their culture is adamantly against any internal vaginal exams during pregnancy. After educating them on vaginal exams in pregnancy, the nurse practitioner goes on to communicate that it is an acceptable decision to decline the exam at this visit. Which of the following patient-centered care principles is the nurse practitioner demonstrating? - CORRECT ANSWER Respect for the patient's values and preferences
Which of the following is an example of a technique used to decrease bias in a randomized control trial? - CORRECT ANSWER Placebos identical in appearance and packaging to the corresponding active drugs
The NP is reviewing data comparing enoxaparin versus rivaroxaban for treatment of pulmonary embolism. A cost-benefit analysis is an example of which component of evidence-based practice change? - CORRECT ANSWER Evaluation
A 61-year-old woman presents to the clinic for a colposcopy following an abnormal Pap smear. The clinic has a consent form for this procedure. Which of the following conditions must be met to fulfill legal requirements for informed consent? - CORRECT ANSWER She must demonstrate that she fully understands the procedure
A nurse practitioner is evaluating a research article. Which of the following statements accurately describes the sample size of the study? - CORRECT ANSWER The sample size is the total number of participants in the study
A patient presents to a cardiology clinic for an evaluation of dyspnea. After completing a comprehensive cardiac evaluation and physical examination, the NP rules out a cardiac etiology for the dyspnea. Which of the following is the most appropriate approach to refer the patient to a pulmonologist? - CORRECT ANSWER Communicate with the pulmonologist via telephone directly explaining the patient's cardiac workup and need for further evaluation of dyspnea
Who is generally tasked with taking care of the emotional needs of the patient and family when working within a pediatric palliative care interdisciplinary team? - CORRECT ANSWER Child life specialists
A nurse practitioner is presenting at a primary care health care provider conference in Philadelphia. The topic of the presentation is the initiation of end of life discussions with patients with end-stage organ failure. When would be the appropriate time to have an end of life discussion with this patient population? - CORRECT ANSWER Initial encounter
The NP is interpreting a research article. Which value is used to determine statistical significance? - CORRECT ANSWER P-value
Which of the following outpatient provider care models would lead to the greatest organizational cost savings and positive patient outcomes? - CORRECT ANSWER Nurse practitioner only full-time
A 16-year-old girl presents to the clinic to obtain contraception. She is not married and is currently living with her parents. She states that she does not want her parents to find out about her decision to start birth control. Which of the following regulations would apply regarding adolescent consent and confidentiality? - CORRECT ANSWER Consent and confidentiality laws vary from state to state
The D-dimer test has a sensitivity of approximately 95%. What does the sensitivity of the D-dimer test indicate? - CORRECT ANSWER The proportion of people with venous thromboembolism who test positive
The nurse practitioner is providing care to a 17-year-old girl. At the end of the exam, the patient has exited the room. The patient's mother confides in the nurse practitioner, "My daughter's behavior is out of control and she is very disrespectful." Which of the following responses is the most appropriate? - CORRECT ANSWER "Teenagers can be challenging. I would encourage you to set reasonable expectations and maintain open communication."
A 78-year-old man presents to the clinic for a follow-up after an emergency department visit for acute bronchitis. He reports he could not get the inhaler prescribed to him because it was too expensive. The man states, "Since my grandson started going to the bank for me, my account always runs out of money before the end of the month." Which of the following types of elder abuse might this indicate? - CORRECT ANSWER Exploitation
A clinician is considering prescribing oxycodone to a patient. Which of the following are opioids appropriate to treat? - CORRECT ANSWER Kidney calculus
A 4-year-old girl presents with her grandmother for her well-child visit. The child is attentive, her speech is easily understood, and she is able to talk in full, meaningful sentences. Fine motor skills are developing well, as you can see the child drawing and trying to write her own name. In order to assess her gross motor development, you ask the grandmother what sort of activities she is able to do outside at home or in the park. Which of the following activities should the child have attained since her 3-year well-child visit? - CORRECT ANSWER Kicking a ball short distances
A 38-year-old woman who suffers from insomnia presents for her follow-up appointment. Today, she reports poor sleep 3 to 4 nights per week on average since her appointment last month. Considering the principles of motivational interviewing, which response would be most effective for continuing to assess her problem or providing appropriate interventions for her insomnia? - CORRECT ANSWER Can you describe a typical night? [Show Less]