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PSI FNP Practice Exam Questions With Solved Answers.
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PSI FNP Practice Exam Questions With Solved Answers.
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Name: Score:162 Multiple choice questions
Term 1 of 162
A 40 year old male patient presents with a 2 week history of rectal pain and itching. He reports a
past history of constipation, and finding spots of bright red blood on toilet paper several times a
week. Rectal exam reveals a tender, swollen, bluish, ovoid mass. The stool guaiac test is negative.
Which of the following actions should the nurse practitioner take?
Prescribe diphenoxylate/atropine( Lomotil)
Schedule a colonoscopy to rule out colon cancer
Repeat the guaiac test three times and obtain complete blood count
Prescribe bulk forming agents and hydrocortisone suppositories.
,Term 2 of 162
Expected spriometry readings when the patient has chronic emphysema include:
Increased abdominal pain when patient attempts to raise thigh against your hand or when
asking the patient to extend their right leg at the hip. Indicates Appendicits
Intususseption or volvulus.
Intuseusseption and volvulus are surgical emergencies. Delay releasing the invaginated or
"telescoped" bowel (intususseption), or releasing the twisted bowel (volvulus) may result in
tissue death and gangrene, perforation, peritonitis, and/or sepsis, and fatality. There is also
a high rate of intususseption and volvulus among infants with cistic fibrosis.
Increased total lung capacity (TLC).
Residual volume is increased, Volume Capacity is decreased, FEV-1 in decreased, and total
lung capacity is increased with emphysema. RV, VC, and FEV-1 spirometry readings are the
same whether COPD is due to chronic emphysema or chronic bronchitis, however, TLC is
normal or only slightly increased with chronic bronchitis.
avoidance of excessive sun exposure.
Avoidance of excessive sun exposure is the most accepted recommendation for prevention
of skin cancer. All the other items are recommended by particular groups, but are not as
widely accepted. Clinicians should remain alert for suspicious lesions in fair-skinned men
and women >65 years, those with atypical moles, those with > 50 moles. These groups have
a substantially increased risk for melanoma.
,Term 3 of 162
A male patient with chronic atrial fibrillation takes a generic brand of Coumadin (warfarin). He
should report all of these to his health care provider EXCEPT:
Intususseption or volvulus.
Intuseusseption and volvulus are surgical emergencies. Delay releasing the invaginated or
"telescoped" bowel (intususseption), or releasing the twisted bowel (volvulus) may result in
tissue death and gangrene, perforation, peritonitis, and/or sepsis, and fatality. There is also
a high rate of intususseption and volvulus among infants with cistic fibrosis.
6 weeks.
The half-life of levothyroxine, the treatment of choice for thyroid replacement, is 7 days.
The earliest that meaningful changes will be observed is at 4-6 weeks. Therefore, the NP
should wait a minimum of 4-6 weeks before checking the patient's TSH.
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.
one missed dose of warfarin.
This patient takes warfarin for prevention of emboli secondary to chronic atrial fibrillation.
According to the NHLBI and ACCP, warfarin is the standard of care when anticoagulation is
required for this condition. Warfarin is a drug with a narrow therapeutic index. This means
that fluctuation in its level (increased or decreased) can potentiall cause big changes in its
therapeutic effect. Consequently, warfarin levels are checked frequently to maintain
therapeutic levels. If changes such as medication substitutions occur, warfarin levels should
be checked in 3-7 days. Levels should be checked minimally every 4-6 weeks once
regulation has occurred. While it is important NOT to omit doses of warfarin, this is the least
important of all the choices because the effect of warfarin lasts beyond 24 hours.
, Term 4 of 162
Research findings have shown that, in order to improve the longevity of a patient who has COPD,
the treatment of choice is:
oxygen
Anticholinergic drugs
Systemic steroids
Exercise
Definition 5 of 162
Assess for positive McBurney's point tenderness, Rovsing's sign, the psoas sign, and obturator
sign.
Positive murphy's sign
Appendicitis is a common cause of acute abdominal pain.
Rovsing's sign
Which of the following is not a characteristic of the s3 heart sound?
Term 6 of 162
After a 3-week camping trip, an 11-year old is seen for a target lesion with central clearing,
located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and
generalized musculoskeletal pain for several days. Pharmacologic management of this condition
includes:
trimethoprim-sulamethoxazole (Bactrim)
Azithromycin (Zithromax)
Metronidazole (Flagyl)
Doxycycline (Doryx)
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