PA Exam Flashcards
An advanced practice registered nurse (APRN) is leading a project team to ensure that during the discharge process patients are able to describe two ways home care instructions will be followed after release. The team is developing outcomes that will meet the criteria of the SMART tool.
Which outcome should the APRN approve for the project?
80% of patients receiving home care instructions will describe at least two ways they will follow the instructions.
All patients will describe at least two ways they will follow the instructions prior to discharge.
80% of patients receiving home care instructions will describe at least two ways they will follow the instructions prior to discharge.
All patients receiving home care instructions will describe how they will follow the instructions prior to discharge.
80% of patients receiving home care instructions will describe at least two ways they will follow the instructions prior to discharge.
A large healthcare system wants to improve communication between patients, patients’ families, and the healthcare system in order to reduce litigation costs by 20% by the end of the fiscal year. To reach this goal, the system has designated a single representative to communicate with patients and families immediately following each adverse event. An advanced practice registered nurse (APRN) in the quality department has been assigned to continuously monitor this project intervention.
What data should the APRN monitor to determine if this goal is being met?
Number of litigations for each event
Number of events during the fiscal year
Number of stakeholders affected
Number of spokespeople for each event
Number of spokespeople for each event
An advanced practice registered nurse (APRN) is working with an integrated multidisciplinary team and recognizes that team processes need to be strengthened. The APRN suggests a strategy to meet that goal.
Which strategy should the APRN use to meet this goal?
Initiating cross-training
Introducing value-based interviewing
Instituting clinical case review
Identifying clear patient outcomes
Instituting clinical case review
A patient with chronic kidney disease is scheduled for a permanent A/V fistula placement. The patient is experiencing intra-dialysis hypotension. During the physical exam, the advanced practice registered nurse (APRN) notes that the patient has a systolic ejection murmur.
Which order should the APRN make prior to this patient’s surgery?
Potassium level
Stress test
Fistulogram
Echocardiogram
Echocardiogram
A patient with a history of an acute adrenal insufficiency presents to the clinic. The advanced practice registered nurse (APRN) assesses that the patient has increased edema and weight gain from the corticosteroid therapy.
Which action should the APRN take next for this patient?
Order an ACTH stimulation test
Discontinue the corticosteroid
Consult with an endocrinologist
Schedule a CT of the adrenal glands
Consult with an endocrinologist
An advanced practice registered nurse (APRN) is assessing a patient who has experienced mood instability for 10 years. The patient mentions noticing his feet and hands appear to be enlarged.
Which specialty provider should the APRN recommend to assist this patient?
Podiatry
Psychiatry
Endocrinology
Cardiology
Endocrinology
An advanced practice registered nurse (APRN) is evaluating a patient in the clinic. The patient complains about having diarrhea for the last five days, a fever that started the day before, and abdominal bloating. The patient mentions trying to keep hydrated but is finding that goal difficult to achieve.
What is an appropriate question for the APRN to ask during the history and physical?
“Have you traveled abroad recently?”
“Have you been exposed to new cats or dogs?”
“Have you exposed anyone to your infectious stool?”
“Have you eaten any fried or overcooked food within the past week?”
“Have you traveled abroad recently?”
An advanced practice registered nurse (APRN) is caring for a newly admitted Filipino patient and needs to collect a history prior to starting a care plan.
Which fact should the APRN understand about the Filipino culture prior to collecting this data?
Handshakes are discouraged as a greeting.
Patients prefer to be called by their first name.
Providers should sit, attempt to maintain eye contact, and allow periods of silence.
Family members will provide opinions about care without prompting.
Providers should sit, attempt to maintain eye contact, and allow periods of silence.
A non-English speaking patient is seeing an advanced practice registered nurse (APRN) for chronic back pain. The patient speaks Spanish and arrived at the clinic with a bilingual spouse and child. The APRN would like to decrease the language barrier and ensure understanding.
Which action should the APRN take to meet this goal?
Ask the bilingual, adult spouse to assist with translation
Use a Spanish–English dictionary to ensure accurate word translations
Have a clinic nurse who speaks some Spanish speak with the patient
Request a professional interpreter who has healthcare experience
Request a professional interpreter who has healthcare experience
An advanced practice registered nurse (APRN) is discussing the treatment options available to a patient who is homeless and has been diagnosed with HIV. The patient admits that the $8,000 per month cost of the preferred treatment is not fiscally possible.
Which action should the APRN take to assist this patient?
Refer the patient to the case management services
Delay prescribing the medication
Advise the patient to speak with the patient assistance program
Encourage the patient to cut the dose in half
Refer the patient to the case management services
An advanced practice registered nurse (APRN) is evaluating a 96-year-old male for possible pneumonia. The APRN identifies that the patient has pneumonia and requires antibiotics. The APRN is planning multimodal treatments for this patient.
Which system should the APRN carefully evaluate first before recommending a wide-spectrum antibiotic?
Neurologic
Renal
Dermatological
Endocrine
Renal
A patient receiving antenatal care for a first pregnancy returns for another visit at 20-weeks gestation. The advanced practice registered nurse (APRN) notes that all diagnostic tests indicate the patient is experiencing intrauterine growth restriction and makes recommendations to improve the growth of the fetus.
Which recommendation should the APRN make to this patient?
Take aspirin 325 mg QD
Stop smoking
Take heparin 10000 U bid
Increase physical activity
Stop smoking
An adult patient with a long history of alcohol abuse is being evaluated by the advanced practice registered nurse (APRN) for chronic lower-back pain.
Which action the APRN take?
Encourage use of acetaminophen
Prescribe meperidine 100 mg q3h, as needed
Encourage use of naproxen sodium
Recommend calcium intake of 2000 IU QD
Encourage use of naproxen sodium
A patient presents to an advanced practice registered nurse (APRN) for lower-back pain that has been returning intermittently for the past year. Corticosteroids have been tried and optimized with no relief. The APRN notes that previous lumbar cervical spine X-rays and an MRI suggest radiculopathy arthritis.
Which action should the APRN take to assist this patient?
Prescribe a long-acting opioid using the maximum dose
Schedule for outpatient mental health counseling
Prescribe a short-acting opioid using the lowest dose
Schedule reassessment within six to eight weeks
Prescribe a short-acting opioid using the lowest dose
A female patient comes to the emergency department and states that she was raped on her way home from classes at the local college. The advanced practice registered nurse (APRN) notes that the patient appears disheveled, has bruising on her face and thighs, and has abrasions present on her knees, back, and elbows.
Which action should the APRN take?
Develop a relationship with the patient and get consent to collect evidence
Prescribe ulipristal acetate 30 mg once daily for three days
Give a one-time dose of alprazolam 0.1 mg to decrease post-traumatic stress disorder (PTSD) symptoms
Call the police to interview the patient and collect physical evidence
Develop a relationship with the patient and get consent to collect evidence
A 72-year-old patient comes to the clinic for routine follow-up care with an advanced practice registered nurse (APRN). The APRN performs a comprehensive physical exam, which is negative for findings, and then completes advanced care planning services.
Why did the APRN complete this planning for this patient?
It is indicated for this patient’s disease process.
It enhances self-determination and quality of care.
It is required by CMS for a patient of this age.
It increases billing services for the practice.
It enhances self-determination and quality of care.
An 82-year-old patient comes to a clinic for routine care. The patient lives alone and has no family living close by.
Which topic should the advanced practice registered nurse (APRN) discuss as part of the plan of care for this patient?
Invoking durable power of attorney for healthcare
Completing the Beers criteria
Reviewing advance directives
Moving into a nursing home
Reviewing advance directives
An older adult has a history of taking multiple medications for gastroesophageal reflux disease. The advanced practice registered nurse (APRN) reviews the medications and decides to discontinue the patient’s proton pump inhibitor.
Which effect of this medication prompted the APRN to remove this prescription?
Increased risk for Helicobacter pylori
Increased rate of bone fracture
Increased risk for hypertension
Increased rate of hypermagnesemia
Increased rate of bone fracture
An advanced practice registered nurse (APRN) is examining a 96-year-old patient who is complaining of an ear infection. The patient reports currently taking four pills every day. The APRN decides to respond to that information by taking a course of action recommended by the goals of geriatric care.
Which action should the APRN take for this patient?
Write the reason for the medication on the patient’s prescription
Identify the strongest antibiotic to take to prevent a super infection
Add a medication to avoid a yeast infection
Avoid any additional medications and wait to see if it resolves
Write the reason for the medication on the patient’s prescription
An advanced practice registered nurse (APRN) is treating a 96-year-old patient who is taking six different medications for chronic diseases. The APRN wants to improve compliance with the medications while avoiding pill burden.
Which action should the APRN take to meet these goals?
Reduce the frequency of all medications to once a day
Use combination medications to minimize prescriptions
Change the medications to liquid form
Encourage the patient to grind up all pills together
Use combination medications to minimize prescriptions
An advanced practice registered nurse (APRN) reviews a patient’s history and notes that prednisolone is being taken for severe allergies even though the patient no longer has allergy symptoms. The APRN decides to stop this medication and reviews the history again to determine if the medication must be discontinued gradually instead of abruptly.
Under which circumstance should the APRN discontinue this medication gradually?
If the patient has been receiving 20 mg daily for the past four days
If the patient has been receiving 10 mg daily for the past six days
If the patient has been on the medication for four weeks
If the patient has been on the medication for two weeks
If the patient has been on the medication for four weeks
n elderly patient with a recent history of several falls is discussing driving privileges with an advanced practice registered nurse (APRN). The patient mentions the desire to remain both mobile and independent.
Which initial action should the APRN take to assist this patient?
Refer to registry of motor vehicles for a vision screening
Report to authorities for unsafe driving
Call the family to discuss the patient’s concerns
Refer to a rehabilitation facility for screening by occupational therapist
Refer to a rehabilitation facility for screening by occupational therapist
An advanced practice registered nurse (APRN) is conducting a follow-up appointment with an older patient who has recently been diagnosed with depression, constipation, and back pain. The APRN reviews the patient’s medications and notes prescriptions for pain management on the list.
Which recommendation should the APRN make to this patient?
Encourage the patient to follow a low residue diet and keep a food diary
Drink at least five glasses of water per day and switch to lower fat foods
Modify diet to include more fiber and increase fluid intake
Decrease fruit juices and soda intake
Modify diet to include more fiber and increase fluid intake
An advanced practice registered nurse (APRN) is examining a 70-year-old patient for complaints of fatigue, constipation, and dentures that are suddenly not fitting well. The APRN suspects dehydration.
Which diagnostic tool will confirm this diagnosis?
Lipid profile
Complete metabolic panel
Urine culture and sensitivity
Abdominal X-ray
Complete metabolic panel
