PSI FNP PRACTICE REVIEW NEWEST ACTUAL EXAM WITH
COMPLETE QUESTIONS AND CORRECT VERIFIED ANSWERS
(DETAILED ANSWERS) ALREADY GRADED A+ 100%
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A 14yo male with bronchitis is being treated with fluids and expectorants. He returns to
the clinic with a fever of 103F, right pleuritic chest pain, and green sputum. Which of the
following examination results would be expected?
A. Right lower lobe crackles
B. Decreased Fremitus
C. Bilateral Wheezing
D. Normal Percussion - <<ANSWER>>A. Right lower lobe crackles.
2 year old child is diagnosed with radial head subluxation ("nursemaid's elbow"). After
closed manipulation, the best indication of successful treatment is that:
A. Swelling dissipates immediately
B. Pulse and sensation are restored
C. The child quickly begins to use the affected arm
D. A click is felt while the child is extending and rotating the arm - <<ANSWER>>C. The
child quickly begins to use the affected arm.
Which of the following is NOT a characteristic of the S3 heart sound? -
<<ANSWER>>The sound is high-pitched and occurs just prior to the S1 heart sound.
The S3 heart sound is low-pitched and occurs just after the S2 heart sound. It is
produced by rapid ventricular filling and is best auscultated in the mitral area. It is a
common finding with right-sided heart failure, rapid growth, and the last trimester of
pregnancy.
Following the finding of prostate gland abnormalities on DRE, the NP orders the
appropriate labs. Whem preparing to review lab reports with the patient, the nurse
practitioner knows all of the following are true EXCEPT: - <<ANSWER>>normal PSA is
10ng/ml or less.
Normal PSA is 4ng/ml or less. PSA levels greater the 4 and less than 10 are associated
with BPH. A 10 or greater PSA level suggests prostate cancer. Positive serum acid
phosphatase is associated with malignancy of the prostate gland with bone metasasis.
,A 66 yo female presents to your clinic. She states that yesterday evening she had chest
pain for 20-30 minutes. Which finding most strongly correlates with myocardial
infarction? - <<ANSWER>>Elevated Troponin I levels
An elevated creatinine kinase (CK) is not diagnostic of a myocardial infarction (MI). CK
may be elevated from an IM injection, surgery, ot any type of extensive skeletal muscle
trauma or prolonged, strenuous physical exertion. ST segment depression on EKG
usually indicates an ischemic myocardium, but, not necessarily, one post-MI. Elevated
ST seghments reflect mycardial damage. MB bands are specific for myocardial smooth
muscle. If these are elevated, the patient MAY HAVE had a very recent MI. The most
accurate marker of cardiac damage, because it is more specific and sensitive than CK
MB, is a troponin measurement.
What is a secondary cause of hyperlipidemia? - <<ANSWER>>hypothyroidism
Hypothyroidism is a common secondary cause of hyperlipidemia. In the evaluation of a
patient with hyperlipidemia, a TSH should always be checked and corrected before
attempting treatment for hyperlipidemia. Other possible causes of seconday
hyperlipidemia include pregnancy, excessive weight gain, excessive alcohol intake,
insulin resistance or deficiency, obstructive liver disease, and uremia. Some
medications can produce secondary hypothyroidism too: thiazide diuretics, some beta-
blockers, oral contraceptives, and corticosteroids.
A 35-yo male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency,
and reduced for of stream. The nurse practitioner suspects acute bacterial prostatitis.
The NP would appropriately collect all of the following specimens EXCEPT a: sterile in-
and-out catheter urine specimen. - <<ANSWER>>A sterile in-and-out catheter
specimen would identify only organisms in the bladder and would not differentiate
between bladder, kidney, or prostate site infection. The sequence for obtaining
specimens when prostat infection is suspected is: 1. voided urethral urine, 2. Voided
mid-stream bladder urine, and 3. voided post-prostate massage urine.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What should the
nurse practitioner advise her to do to minimize her risk of pregnancy? -
<<ANSWER>>Double today's dose and tomorrow's dose and use a barrier method for
the rest of the month.
If 2 mills are missed on consecutive days, the next 2 days' doseages should be doubled
and a barrier method recommended for the remainder of the cycle.
A 50yo, non-smoker, with no co-morbidity presents to the clinica and is diagnosed with
pna. His vital signs are normal except for temperature of 101.6 degrees. A sputum
specimen is collected and sent for culture and sensitivity. What action should the nurse
practitioner take today? - <<ANSWER>>Start Clarithromycin (Biaxin) 500mg 2 times a
day for 10 to 14 days.
Most treatment guidelines for outpatient pna in non-smokers without co-morbidity and
60 years of age or younger, recommend erythromycin or another macrolide like Biaxin.
, Pcn s indicated for patient swith pneumococcal pna and ciprofloxacin is recommended
for Legionella species.
A 38 year old patient is being treated the by the NP for heavy vaginal bleeding
secondary to multiple uterine leiomyomas. Her uterus is greater than 12 weeks
gestational size, her hematocrit is 28%, and she has not responded to hormonal
therapy. Which of the following would be the most appropriate intervention at this time?
- <<ANSWER>>Obtain a gynecological consultation
Gynecological consultation is recommended for a patient with a uterus greater that 12
weeks gestational size, significant anemia (hct <30),. o a normal endometrial biopsy
with failure to respond to hormonal therapy.
Which of the following would be an appropriate alternative to erythromycin therapy in an
18 year old patient with Mycoplasma pneumoniae infection?
A. Azithromycin (Zithromax)
B. Cephalexin (Keflex)
C. Amoxicillin
D. Clindamycin (Cleocin) - <<ANSWER>>A. Azithromycin
A 10-month old presents with a rash, runny nose, and cough. Examination reveals a
cluster of tiny white papuls with an erythematous base on the buccal mucosa. What
does this suggest?
A. Scarlet fever
B. Rubella
C. Erythema infectiosum
D. Measles - <<ANSWER>>D. Measles
Office Spriometry performed with an albuterol nebulizer treatment can confirm a
diagnosis of asthma because it indicates:
A. Oxygen saturation
B. Whether airway obstruction is from pulmonary fibrosis
C. Chronic carbon dioxide retention
D. Whether a patient has reversible airway obstruction - <<ANSWER>>D. Whether a
patient has reversible airway obstruction
An 18yr old patient presents with complaints of maxillary facial pain and yellow nasal
discharge for 14 days. What is the appropriate initial pharmacologic intervention?
A. Amoxicillin-Clavulanate (Augmentin)
B. Ceftriaxone (Rocephin)
C. Levofloxacin (Levaquin)
D. Erythromycin - <<ANSWER>>A. Amoxicillin-Clavulanate (Augmentin)
Which of the following is the leading cause of cancer-related deaths in the majority of
women?
