Questions regarding sensitive topics

 

Question 11 pts

 

The client tells you he takes aspirin every day. What question should be asked next?

Group of answer choices

“Does the drug upset your stomach?”

 

“Was this prescribed by your provider?”

 

“Have you had any prolonged bleeding or bruising?”

 

“Why are you taking aspirin daily?”

 

 

Flag question: Question 2Question 21 pts

 

You realize that as an Advanced Practice Nurse you must ask questions regarding sensitive topics. To be most effective you employ the basic principles that guide responses to sensitive topics. The most important rule is:

Group of answer choices

Be nonjudgmental

 

Be focused

 

Be direct

 

Be succinct

 

 

Flag question: Question 3Question 31 pts

 

Cultural competence is best enhanced when the health care provider:

Group of answer choices

Uses self-awareness and reflection.

 

Relies on group stereotypes

 

Personally values health

 

Uses a single-focus approach

 

 

Flag question: Question 4Question 41 pts

 

You are assessing Jenna’s broken arm in the ER and you suspect she may be a victim of violence. What statement triggered your concern?

Group of answer choices

“Can you call my boyfriend?”

 

“It really hurts.”

 

“I was in the ER last month for a cold.”

 

“I hurt it about 4 days ago.”

 

 

Flag question: Question 5Question 51 pts

 

You are going to organize a BP screening fair at the mall. You are involved in

Group of answer choices

Early prevention

 

Tertiary prevention.

 

Primary prevention

 

Secondary prevention

 

 

Flag question: Question 6Question 61 pts

 

Your patient presents with left elbow pain, as you document his HPI you note his c/o swelling.
In your symptom analysis this would be considered:

Group of answer choices

Radiation

 

Associated symptom

 

Quality

 

Severity

 

 

Flag question: Question 7Question 71 pts

 

Your patients daughter is explaining to you why her mother, who has dementia is here. Her mother is not able to articulate the answer. This is an example of…

Group of answer choices

chief complaint

 

Family History

 

Objective information

 

subjective information

 

 

Flag question: Question 8Question 81 pts

 

Mr. Bill presents to your office for a physical. You note that his BMI is 27. You inform him that this is considered…

Group of answer choices

Borderline

 

Normal for his height

 

Obesity

 

Overweight

 

 

Flag question: Question 9Question 91 pts

 

A 44 year old man who admits to drinking “a few beers now and then” presents for examination. After obtaining an excellent health history and performing a physical examination. you suspect he is a heavy drinker. Your next action is to:

Group of answer choices

confront the patient with your observation

 

obtain liver enzymes

 

administer the CAGE questionnaire

 

You need to explain that looks like something he will need to work on in the future

 

 

Flag question: Question 10Question 101 pts

 

You are meeting for the first time a 14 yr old female patient. You would want to include the following in your exam.

Group of answer choices

TSH & T4

 

HCG & GC

 

HEADS & RAFFT

 

CBC & PPD

 

 

Flag question: Question 11Question 111 pts

 

As the NP you have given your patient the mini-mental exam. The patient scored 11. Given that the maximum score is 30, What does this score tell you?

Group of answer choices

The patient has severe cognitive impairment

 

The patient is depressed

 

The patient is uneducated

 

The patient has moderate cognitive impairment

 

 

Flag question: Question 12Question 121 pts

 

Which of the following is NOT one of the components of the adult health history?

Group of answer choices

Identifying data

 

History of present illness

 

Physical examination

 

Review of systems

 

 

Flag question: Question 13Question 131 pts

 

Mr. Sherman is a 45 yr. old accountant who presents to your office for an annual routine exam. He reports that he is a smoker (22Pk Yr. Hx). He states that he drinks 4 to 6 cans of beer a day, which he finds helps him to wind down after work. He denies any allergies. He denies any medications. His family history is positive for heart disease. His major leisure activity is watching television. He rarely exercises, but occasionally plays softball on the weekend. He is recently divorced and lives alone in a studio apartment. He has no children. On physical exam you find that his height is 66 in., weight 90 kg (198 lbs), and BP 148/90.

What health problems does Mr. S. present with?

Group of answer choices

Alcohol abuse, depression related to recent divorce, high-fat diet, obesity, hypertension, lives alone, overnutrition, muscle atrophy

 

Alcohol abuse, exercise intolerance, inactivity, hypertension, obesity, lives alone, recent divorce, social isolation.

 

Tobacco abuse, obesity, depression, exercise intolerance

 

Tobacco abuse, alcohol abuse, stress associated with work & recent divorce, inactivity, family history of heart disease, obesity, elevated blood pressure.

 

 

Flag question: Question 14Question 141 pts

 

Mr. Sherman is a 45 yr. old accountant who presents to your office for an annual routine exam. He reports that he is a smoker (22Pk Yr. Hx). He states that he drinks 4 to 6 cans of beer a day, which he finds helps him to wind down after work. He denies any allergies. He denies any medications. His family history is positive for heart disease. His major leisure activity is watching television. He rarely exercises, but occasionally plays softball on the weekend. He is recently divorced and lives alone in a studio apartment. He has no children. On physical exam you find that his height is 66 in., weight 90 kg, and BP 148/90.

Which of the following is not true regarding Mr. Sherman’s weight?

Group of answer choices

He’s at risk for obstructive sleep apnea

 

He’s not at increased risk; his weight is WNL (within normal limits)

 

He’s may be self treating depression with food.

 

He’s at risk for CAD

 

 

Flag question: Question 15Question 151 pts

 

Mr. Sherman is a 45 yr. old accountant who presents to your office for an annual routine exam. He reports that he is a smoker (22Pk Yr. Hx). He states that he drinks 4 to 6 cans of beer a day, which he finds helps him to wind down after work. He denies any allergies. He denies any medications. His family history is positive for heart disease. His major leisure activity is watching television. He rarely exercises, but occasionally plays softball on the weekend. He is recently divorced and lives alone in a studio apartment. He has no children. On physical exam you find that his height is 66 in., weight 90 kg, and BP 148/90.

What risk factors for coronary artery disease does Mr. S. have at this time?

Group of answer choices

Smoking, alcohol abuse, family history, lives alone.

 

Family history, alcohol abuse, depression.

 

Family history, obesity, hypertension

 

Smoking, elevated blood pressure, family history, obesity, age 45.

 

 

Flag question: Question 16Question 161 pts

 

Mr. Jones is a new patient and newly diagnosed diabetic. You realize that in order to get reimbursed at a higher level for the diabetic education you have done, you must document the time spent on this education at least what percentage of the visit.

Group of answer choices

more than 50% of visit

 

at least 25% of visit

 

at least 75% of visit

 

more than 85% of visit

 

 

Flag question: Question 17Question 171 pts

 

Susie Lee  (25) presents for a checkup to your office. You have not seen her before. She was last seen by the MD in your group for a URI (upper respiratory infection) 4 years ago. Todays visit would be considered_________ according to the CPT definition.

Group of answer choices

an established patient

 

concurrent care

 

a new patient

 

billable at a higher level

 

 

Flag question: Question 18Question 181 pts

 

Your patient is seen for “ankle pain” .  In your note you document that he c/o pain in the left lateral ankle radiating to the back of the heel. Pain is a 6 (1-10 scale), and worse when he puts pressure on it. He denies swelling, bleeding or bruising. He’s taken Advil 400mg twice, which helped minimally.  In order to have a complete HPI for your CPT code, what is missing?

Group of answer choices

Any family members with osteoarthritis?

 

What meds is he on?

 

When did it begin?

 

What does he think it is?

 

 

Flag question: Question 19Question 191 pts

 

The keys to select the right level for billing include:

Group of answer choices

History, counseling, time

 

History, exam, decision making

 

Time, coordination of care, exam

 

Exam, decision making, time

 

 

Flag question: Question 20Question 201 pts

 

When performing a history & physical on a pediatric patient, which important factor affect the outcome the most:

Group of answer choices

child’s health

 

child’s fears

 

child’s verbal ability

 

child’s development level

 

 

Flag question: Question 21Question 211 pts

 

In medical billing the abbreviation CPT stands for:

Group of answer choices

Current Procedural Terminology

 

Compendium of Procedures and Therapies

 

Current Pricing Tier

 

Clinical Practice Terminology

 

 

Flag question: Question 22Question 221 pts

 

When obtaining a health history from an older client, which characteristics of the older client must be taken into consideration?

Group of answer choices

The older client requires a lot of repetition because the IQ declines with the aging process.

 

Auditory acuity is the most common sensory loss in the aged population and may hinder the interview.

 

An older client’s response time to answering a question is just as quick as that of a young client.

 

The older client responds to pain sensation with the same intensity as a young client.

 

 

Flag question: Question 23Question 231 pts

 

Mr. Williams is a new patient and has no complaints, but wants a physical. His physical exam is unremarkable but some of the findings from his history are concerning. Of the following, which would NOT put him at risk ?

Group of answer choices

3 beers/day

 

BMI > 26

 

waist of 32 inches

 

loose fitting false teeth

 

 

Flag question: Question 24Question 241 pts

 

The most important question to ask as you build your HPI is:

Group of answer choices

Have you ever had this before?

 

Men, women, or both

 

What time did it start?

 

have you had nausea?

 

 

Flag question: Question 25Question 251 pts

 

As an APN you believe strongly in anticipatory guidance and prevention education. You explain that all of the following  are steps to address smoking except:

Group of answer choices

advise

 

assist

 

assess

 

arrange

 

admit

 

 

Flag question: Question 26Question 261 pts

 

Limiting public smoking is an example of tertiary prevention

Group of answer choices

True

 

False

 

 

Flag question: Question 27Question 271 pts

 

James is a 17 yo old patient who presents for a school physical. You have set aside time for screening prevention. Based on the leading cause of mortality for this student what should you discuss..

Group of answer choices

depression

 

HIV risk

 

seat belt use

 

vaccination status

 

 

Flag question: Question 28Question 281 pts

 

Which of the following women should have screening for cervical cancer?

Group of answer choices

a 19 yo virgin

 

a 21 yo  with one male partner

 

An 18 yo who has a history of genital warts

 

a sexually active 16 yo

 

 

Flag question: Question 29Question 291 pts

 

Larry 25yo male presents to have a TB test read. This visit should be billed at:

Group of answer choices

99213

 

99212

 

99211

 

99214

 

 

Flag question: Question 30Question 301 pts

 

Which of the following patients is least likely to become an alcohol abuser?

Group of answer choices

a 19 yo college student who binges on alcohol but only on the weekends

 

a 70 yo male who feels better after drinking rum in the morning

 

a 50yo construction worker who drinks 1 beer nightly while watching baseball on TV

 

a 30 yo nurse who complains that her mother’s comments about her recreational drinking are starting to annoy her and her spouse

 

 

Flag question: Question 31Question 311 pts

 

Ted, who is 15yo has just moved into the community and is staying in a foster home temporarily. There is no record of immunization. His foster mother wants him to be checked before he enters the local high school. Which of the following does he need?
Group of answer choices

All of the above

 

meningococcal

 

Tdap

 

Measles-Mumps-Rubella (MMR)

 

 

Flag question: Question 32Question 321 pts

 

A sedentary, obese 52 yo woman is diagnosed with HTN and states: “It is going to be hard to diet, exercise, and take these pills”. Which of the following responses is the least helpful?

Group of answer choices

“Could you start with reducing the amount of salty foods in your diet?”

 

“Tell me what you feel will get in your way of improving your health?”

 

“Perhaps you could try taking your medication when you brush your teeth”

 

“You really need to try and improve your health.”

 

 

Flag question: Question 33Question 331 pts

 

A NP is evaluating an 85yo male from a nursing home. The NP instructs the patient to remember the words orange, street, and tiger. The patient is instructed to repeat these words back to the NP in 10 minutes. Which of the tests is being described?

Group of answer choices

Minnesota Multphasic Personality Inventory (MMPI)

 

The CAGE test

 

Beck Inventory

 

Mini-Mental status exam

 

 

Flag question: Question 34Question 341 pts

 

In doing a cultural assessment on your patient all of the following are components of the assessment except:

Group of answer choices

What are the roles in the family?
 

What religious influences may affect care?

 

What is the patient’s income?

 

What are the patient’s personal belief about health?

 

 

Flag question: Question 35Question 351 pts

 

When caring for a patient with sensitive issues, which of the following is the most therapeutic approach?
Group of answer choices

Be vague so you don’t offend the patient.
 

Push to get the accurate and necessary answers
 

Offer the patient the opportunity to ask questions
 

Apologize for having to ask difficult questions
 

 

Flag question: Question 36Question 361 pts

 

The SCOFF screening tool is used to diagnose eating disorders.

 

Group of answer choices

True

 

False

 

 

Flag question: Question 37Question 371 pts

 

When researching the elderly population, what is the fastest growing age range?

Group of answer choices

81-84 years
 

85 and older
 

71-75 years

 

76-80 years
 

 

Flag question: Question 38Question 381 pts

 

Your patient is a 43 year old female in today for an annual physical exam. Her history is unremarkable, she has no new diagnosis or surgeries since seen last year and is otherwise health. When you begin questioning her about her cardiac ROS, she becomes tearful and states:” I just know Im going to have a heart ache some day.” Your best response would be:

Group of answer choices

If I were you, I would get an EKG and have a cardiac stress test – I can order those for you today.

 

Im sure you’ll be just fine, you don’t have a cardiac history.

 

You don’t need to worry about that, you’re young and healthy.

 

It sounds like this is a big concern of yours, can you tell me more about it?

 

 

Flag question: Question 39Question 391 pts

 

As a nurse practitioner, you have been asked to serve on a committee to assess the social determinants of health for a community. Of the following considerations, choose the one that is not a social determinant of health.

Group of answer choices

Ease of access to fresh food.

 

The prevalence of diabetes in a community.

 

Accessability for persons with disabilities.

 

Availability of safe recreational areas.

 

 

Flag question: Question 40Question 401 pts

 

When screening a patient for their risk of  experiencing violence/domestic violence, there are 2 important questions to ask. Of the following, choose both appropriate questions:

Group of answer choices

Have you ever been hit by your partner?

 

Has your partner ever given you a sexually transmitted disease?

 

How many times have you been to the ER in the last year?

 

Have you been forced to have sex by your partner?