EXAM 1 FNP 511 QUESTIONS
ANSWERED CORRECTLY LATEST
UPDATE
5. 600 A 67-year-old woman with a 30-pack-year history of smoking presents for a
routine annual physical examination. She complains of being easily short of breath and
is frequently fatigued. Physical examination reveals diminished breath sounds,
hyperresonance, and hypertrophied respiratory accessory muscles. Her complete blood
count (CBC) results reveal that her hematocrit level is elevated. Her pulmonary function
test (PFT) results show increased total lung capacity. Which diagnosis is most likely?
A. Bronchogenic carcinoma
B. Chronic obstructive pulmonary disease (COPD)
C. Chronic bronchitis
D. Congestive heart failure
Leik, Maria T. Codina, MSN, ARNP, FNP-C, AGPCNP-BC. Family Nurse Practitioner
Certification Intensive Review, Fourth Edition (p. 1210). Springer Publishing Company.
Kindle Edition. - Answer B) Chronic obstructive pulmonary disease (COPD). COPD is a
progressive lung disease that includes emphysema and chronic bronchitis. The most
common risk factor for COPD is long-term cigarette smoking (80%-90%). Another cause
is alpha-1 antitrypsin deficiency and chronic fume exposure. The three cardinal
symptoms of COPD are dyspnea, chronic cough, and sputum production. The lungs are
hyperinflated, which changes the shape of the chest and diaphragm, making the
mechanics of breathing more difficult. Excess mucus and obstructed airflow from
progressive thickening and stiffening of the airways diminish breath sounds. COPD
creates a high hematocrit percentage because of chronic hypoxemia.
Leik, Maria T. Codina, MSN, ARNP, FNP-C, AGPCNP-BC. Family Nurse Practitioner
Certification Intensive Review, Fourth Edition (pp. 1254-1255). Springer Publishing
Company. Kindle Edition.
A middle-aged hypertensive man presents to the public health clinic with complaints of
an acute onset of fever, chills, and cough that is productive of rusty-colored sputum.
The patient reports episodes of sharp pains on the left side of his back and chest
whenever he is coughing. His temperature is 102.2°F, pulse is 100 beats/min, and blood
pressure is 130/80 mmHg. The urinalysis does not show leukocytes, nitrites, or blood.
These findings are most consistent with: A. Atypical pneumonia
B. Upper urinary tract infection
, C. Bacterial pneumonia
D. Acute pyelonephritis
Leik, Maria T. Codina, MSN, ARNP, FNP-C, AGPCNP-BC. Family Nurse Practitioner
Certification Intensive Review, Fourth Edition (p. 1214). Springer Publishing Company.
Kindle Edition. - Answer C) Bacterial pneumonia. The most common cause of bacterial
pneumonia is Streptococcus pneumoniae. Haemophilus influenzae, Chlamydia
pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila are other bacteria
that cause pneumonia. Typically, pneumonia comes on very quickly; the patient has
high fever/chills, productive cough with yellow or brown sputum, and shortness of
breath, and may have chest pain with breathing/coughing. The gold standard for
diagnosing bacterial pneumonia is the chest x-ray, which shows infiltrates and/or lobar
consolidation. Older people can have confusion or a change in their mental abilities. In
patients with bacterial pneumonia, it is important to determine whether bacteria are
present in the urine, in order to identify appropriate antibiotics to treat the bacteria.
Leik, Maria T. Codina, MSN, ARNP, FNP-C, AGPCNP-BC. Family Nurse Practitioner
Certification Intensive Review, Fourth Edition (p. 1258). Springer Publishing Company.
Kindle Edition.
A patient has been taking albuterol via a metered-dose inhaler for a month and remains
in the yellow zone. Which of the following statements is true?
A. Medication should be lowered to produce desired effects
B. The patient is at 50% to 80% of their personal best
C. The patient is at 80% to 100% of their personal best
D. Current medication dosage places the patient at risk for hypoxia
Leik, Maria T. Codina, MSN, ARNP, FNP-C, AGPCNP-BC. Family Nurse Practitioner
Certification Intensive Review, Fourth Edition (p. 1228). Springer Publishing Company.
Kindle Edition. - Answer B) The patient is at 50% to 80% of their personal best.
Spirometer readings are used to assess a patient's personal best. The green zone is in
the range of 80% to 100% expected volume, the yellow zone is in the range of 50% to
80% expected volume, and the red zone is below 50% of expected volume, which
would place the patient at risk for hypoxia. The medication would need to be adjusted,
but not lowered, to produce desired effects.
Leik, Maria T. Codina, MSN, ARNP, FNP-C, AGPCNP-BC. Family Nurse Practitioner
Certification Intensive Review, Fourth Edition (p. 1272). Springer Publishing Company.
Kindle Edition.
What is the priority treatment for a patient who presents with an asthma exacerbation?
A. Prescribe albuterol PRN
B. Teach patient how to properly use a spacer
C. Assess asthma triggers
D. Apply nebulizer treatment
Leik, Maria T. Codina, MSN, ARNP, FNP-C, AGPCNP-BC. Family Nurse Practitioner
Certification Intensive Review, Fourth Edition (p. 1237). Springer Publishing Company.
Kindle Edition. - Answer D) Apply nebulizer treatment. The priority treatment for a
patient with an asthma exacerbation is a nebulizer treatment every 20 minutes as