Test Bank for Nurse Practitioner's Business Practice and
Legal Guide, 7th Edition by Carolyn Buppert,
9781284208542, Covering Chapters 1-118 | Includes
Rationales
The concept of health promotion consists of efforts to prevent rather than to cure
disease or disability. This description best describes:
a. tertiary prevention
b. secondary prevention
c. primary prevention
d. morbidity prevention - ANSWER c
Standards for well child care and health promotion are set forth by the:
a. Task Force on Preventative Services, US Department of Health and Human
services
b. American Academy of Family Physicians
c. American Academy of pediatrics
d. Healthy People 2010 and 2020 - ANSWER c
A 15 yo female comes to the clinic for a health maintenance visit. The patient reports
no complaints. She does well in school, has many friends, and gets along well with
her parents and two siblings. She has recently become sexually active with her
boyfriend of 6mo. The physical exam is normal for her age. What screening, lab
tests, and/or immunizations should the PNP order?
a. Vision, hearing, urinalysis, STD screen, pelvic exam, and immunizations as
needed
b. STD screen, pneumococcal vaccine, pelvic exam, and cholesterol screening as
indicated
c. vision, hearing, STD screen, pelvic exam, and hemoglobin if indicated.
d. Measles vaccine, vision, hearing, STD screen, pelvic exam exam, and cholesterol
screen if indicated. - ANSWER a
Which of the following is the best written chief complaint?
a. 5yo asian female with itchy red rash
b. 1 mo with difficulty feeding
c. 15yo african american female complaining of lower abdominal pain for 3 days
d. 12yo caucasian with itchy eye for 1 week - ANSWER c
The past history should include
a. family history
b. social hx
c. symptom analysis
d. hospitalization - ANSWER d
The family history should include:
a. the health status of the paternal grandparents
b. the living conditions of the family
,c. the work status of the parents
d. school information - ANSWER a
Which of the following statements would be considered subjective data obtained
from the client during the review of systems for the skin?
a. the skin appears dry & excoriated
b. a lesion is noted on the lateral aspect of the right leg
c. there is moderate acne on the forehead and back
d. the patient denies changes in skin texture - ANSWER d
The PNP is completing the ROS on a 4mo. What response from the mother might
indicate a cardiac problem in the infant & require a more thorough history?
a. the baby gets the hiccups often.
b. it takes the baby over 30min to complete a bottle
c. the baby's heart seems to beat rapidly sometimes
d. sometimes the baby sounds congested - ANSWER b
The PNP is obtaining a review of systems on a healthy 8yo girl. It would be important
to include:
a. the date of last breast self-exam.
b. any limitations related to sports participation.
c. the last hematocrit and hemoglobin
d. the last lead screen - ANSWER b
The mother of a 3yo states that her son was completely toilet trained at 18mo. The
PNP explores further, asking:
a. how the mother did the toilet training
b. if the child is dry at night and fully trained for urine and stool day and night
c. at what age did the mother begin toilet training the other child.
d. if the child gets up at night to use the bathroom - ANSWER b
Jasmine, a 5-month-old infant is in the clinic for a well child visit and is sleeping in
her mother's arms. What should the PNP do first?
a. Examine the ears, since this is uncomfortable for the infant.
b. Quickly give any needed immunizations.
c. Begin with assessment of the head and proceed from head to toe.
d. auscultate the heart & lungs while the infant is sleeping. - ANSWER d
The mother of a newborn brings the baby to the clinic because she is afraid
something is wrong with her baby ("his head is so big"). The PNP responds that:
a. "this is normal. The head of a newborn is proportionately large to the rest of the
body"
b. "Yes, this does appear abnormal. I will make an appointment for the baby to be
seen by a neurologist."
d. "your head appears large so it is probably genetic." - ANSWER a
A healthy 12yo female is at the clinic for a well checkup. On physical examination, a
marked elevation of the right scapula and right thoracic hump and spinal curve
abnormally are noted. Spinal films indicate 20 degree curve. The PNP should:
a. refer the patient to an orthopedist
,b. monitor the patient every 3 mo until menarche
c. refer the patient for physical therapy
d. recommend bedrest and back brace - ANSWER a
What is the % of risk an autosomal dominant gene is being passed on to each
offspring?
a. 25
b. 50
c. 100
d. none - ANSWER b
A 13yo female is at the clinic for a routine check up. What presenting symptoms
might alert the PNP to the presence of a possible genetic disorder?
a. <10% on growth chart, Tanner I, and learning difficulties
b. Precocious puberty, developmental delays, gifted piano player
c. Lactose intolerance, frequent ear infections, speech delays
d. Peanut allergy, right-sided weakness, and exhibits bullying behavior - ANSWER a
The parents of a child with cystic fibrosis are considering another pregnancy. They
want to know what their chances are of having another child with cystic fibrosis. The
PNP explains that cystic fibrosis is an autosomal recessive disorder and that each
conception of carrier parents has a:
a. 25% chance of being affected
b. 50% chance of being affected
c. 75% chance of being affected
d. 100% chance of being affected - ANSWER a
The parents of a son with hemophilia are considering another pregnancy. The
mother has been identified as a carrier of the hemophilia gene. What chance does
each female offspring have of having hemophilia.
a. 100%
b. 50%
c. 25%
d. none - ANSWER d
A male with Vitamin D-resistant rickets asks what his chances are of passing his
disease to his parents. The PNP answers:
a. all sons will be affected by only 25% daughters
b. all daughters are affected by only 25% sons
c. 50% of all offspring will have the disease
d. all daughters will be affected but no sons. - ANSWER d
The PNP is following a 15-year-old male adolescent with consistent blood pressure
readings of 132 to 138/84 to 86 mm Hg, which is classified as significant
hypertension. After performing a workup, the PNP determines that the adolescent
has primary hypertension. The most judicious recommendation for therapy is:
A) Diet and exercise counseling and referral to a specialist
B) A diuretic, low-salt diet, exercise, and counseling by a dietician
C) Perform an extensive family history to determine other risk factors
D) A vasodilator, restricted activity, and a low-fat diet - ANSWER a
, The PNP is examining a neonate with a heart murmur. The S2 sound is loudest at
the apex. The respiratory rate is 65 breaths per minute, and the heart rate is 180
beats per minute. Which of the following would be an appropriate action by the PNP?
A) Reevaluate the neonate in 24 hours
B) Increase the number of oral feedings
C) Order cardiac catheterization
D) Refer the neonate to a cardiologist - ANSWER d
A 2-week-old neonate is brought to the clinic with excessive lacrimation of both eyes.
The eyes are clear, with no areas of redness, but the corneas appear hazy. The PNP
explains to the parents the possible diagnosis and treatment as follows:
A) Congenital glaucoma requiring an ophthalmology referral
B) Corneal foreign body requiring fluorescein staining and removal
C) Chalazion requiring treatment with antibiotic eyedrops
D) Allergic conjunctivitis requiring treatment with Benadryl eyedrops - ANSWER a
On examination of a 3-month-old infant the PNP is unable to elicit a red reflex in the
right eye. Previous examinations failed to note the presence or absence of a red
reflex. The PNP's response is to:
A) Reassure the parents that this is not a problem because the infant has dark eyes
B) Note this finding in the infant's chart and check again in a few months
C) Refer the infant to an ophthalmologist to rule out retinal trauma
D) Immediately refer the infant to a pediatric ophthalmologist to rule out a congenital
cataract or retinoblastoma - ANSWER d
A 4-year-old child with chickenpox has vesicles on the skin of the right eyelid. The
child complains of eye pain and blurred vision. The PNP should treat the condition
by:
A) Applying cool compresses to the eye and lesions
B) Prescribing eyedrops containing steroids to decrease inflammation and pain
C) Prescribing polyspoium ophthalmic ointment for the secondary bacterial infection
D) Immediately referring the child to an ophthalmologist - ANSWER d
An adolescent is being seen at a community health center because of recurrent
respiratory tract infections. The complete blood cell count (CBC) with differential
shows a white blood cell count of 20,500 with 35% blast cells. The next step in
managing the adolescent's care is to:
A) Repeat the CBC with differential in 1 week
B) Refer to a specialist in pediatric hematology
C) Perform bone marrow aspiration
D) Hospitalize the adolescent immediately - ANSWER b
A 9-month-old infant was diagnosed with sickle cell disease shortly after birth. The
mother telephones the PNP to report that the infant has a fever of 103.2°F. The best
response to the mother is:
A) "Take the infant to the emergency room immediately."
B) "Administer a dose of ibuprofen, and call back in 6 hours if the fever continues."
C) "Give extra fluids and acetaminophen, and call back tomorrow if the fever
continues."
