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NR509 Final Exam 88 QUESTIONS AND ANSWERS A 35-year-old female with a history of migraines presents to the clinic with worsening symptoms for the past few weeks. She reports waking up at night with headaches and nausea. Her only medication history is oral contraceptive pills (OCPs). Otherwise, she states she is healthy. Which of the following actions if taken by the NP is the best next step?
Options:
a) Order a brain MRI immediately
b) Prescribe a triptan for acute migraine relief
c) Take a further history and perform a very careful neurological
exam
d) Recommend discontinuing OCPs and follow up in 1 month
ANSWER: c) Take a further history and perform a very careful
neurological exam Correct; worsening headaches with nocturnal symptoms and OCP use (a stroke risk factor) necessitate a detailed history and neurological exam to rule out serious causes (e.g., stroke, tumor) before imaging or treatment changes.
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A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination. She asks you privately if her granddaughter has started puberty yet. During the
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examination, the NP notes asymmetric projection of the areola and nipple of the right chest to form a secondary mound above the level of the breast. The left breast is underdeveloped. These assessment findings are consistent with which Tanner Stage of development?
Options:
a) I
b) II
c) III
d) IV
e) V
ANSWER: d) IV
Correct; Tanner Stage IV is characterized by the areola and nipple forming a secondary mound above the breast, with asymmetry common during puberty progression.
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Primary prevention is defined as which of the following?
Options:
a) Interventions designed to prevent disease
b) Early detection and treatment of disease
c) Rehabilitation after disease onset
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d) Management of chronic conditions
ANSWER: a) Interventions designed to prevent disease
Correct; primary prevention focuses on preventing disease onset (e.g., vaccinations, health education).
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Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following statements is true about screening for breast cancer in average-risk women?
Options:
a) Mammography is recommended annually for women aged
40-74
b) Mammography is recommended every 2 years for women
aged 50-74 with insufficient evidence for screening women over the age of 75
c) Mammography is not recommended for women under 50
d) Clinical breast exams are sufficient for women over 75
ANSWER: b) Mammography is recommended every 2 years for
women aged 50-74 with insufficient evidence for screening women over the age of 75 Correct; USPSTF recommends biennial mammography for ages 50-74 (Grade B) and finds insufficient evidence for routine screening beyond 75.
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Which of the following statements is true regarding recommendations by the eighth Joint National Committee (JNC8) for adults aged 60 and older? Select all that apply.
Options:
a) Target blood pressure should be
that if treatment results in SBP <140 and is "well tolerated and without adverse effects to health or quality of life, treatment does not need to be adjusted."
b) In those aged 80 or older, blood pressure targets of 140 to
<150/70 to 80 appear optimal for notable reductions in stroke, cardiovascular events, and all-cause mortality
c) Blood pressure targets should always be <130/80 mmHg
regardless of age
d) Treatment is not recommended for those over 80
ANSWER: a) Target blood pressure should be
mmHg but notes that if treatment results in SBP <140 and is "well tolerated and without adverse effects to health or quality of life, treatment does not need to be adjusted."
ANSWER: b) In those aged 80 or older, blood pressure targets
of 140 to <150/70 to 80 appear optimal for notable reductions in stroke, cardiovascular events, and all-cause mortality