PSI FNP Practice Latest Update 2024-2025 170 Questions and 100% Verified Correct Answers Graded A+
14 year old patient who fell on a outstretched hand complains of proximal forearm pain.X-ray reveals a positive fat pad sign, and the patient is unable to fully extend the elbow.No definitive bony changes are seen on xray. The most likely working diagnosis is:
- upper arm sprain
- lateral epicondylitis
- Radial head fracture
D. Olecranon bursitis - CORRECT ANSWER: C. Radial head fracture.
- year old child is diagnosed with radial head subluxation ("nursemaid's elbow"). After
closed manipulation, the best indication of successful treatment is that:
- Swelling dissipates immediately
- Pulse and sensation are restored
- The child quickly begins to use the affected arm
- A click is felt while the child is extending and rotating the arm - CORRECT ANSWER:
- The child quickly begins to use the affected arm.
A 10-month old presents with a rash, runny nose, and cough. Examination reveals a cluster of tiny white papuls with an erythematous base on the buccal mucosa. What does this suggest?
- Scarlet fever
- Rubella
- Erythema infectiosum
D. Measles - CORRECT ANSWER: D. Measles
A 14yo male with bronchitis is being treated with fluids and expectorants. He returns to the clinic with a fever of 103F, right pleuritic chest pain, and green sputum. Which of the following examination results would be expected?
- Right lower lobe crackles
- Decreased Fremitus
- Bilateral Wheezing
D. Normal Percussion - CORRECT ANSWER: A. Right lower lobe crackles.
A 15 year old patients returns for contraceptive services 2 weeks after a diagnosis of trichomonas vaginitis and treatment with 2gm of metronidazole (Flagyl). She reports that discharge and itching are gone, but she is urinating frequently, accompanied with alot of burning. The patient has not resumed sexual activity and has menstrated since her last visit. Examination reveals mild suprapubic tenderness, no leukorrhea, and a normal wet mount. Gonococcal culture and chlamydia tests are negative. Which diagnostic test should be performed immediately? 1 / 3
- Urine pregnancy test
- Microscopic exam of urine
- Herpes simplex virus culture
D. Repeat chlamydia test. - CORRECT ANSWER: B. Microscopic exam of urine.
A 15 yo malue has a history of cryptorchidism which was surgically repaired. Because of this information, it is essential for the nurse practitioner to teach him about: -
CORRECT ANSWER: testicular self-examination.
Cryptorchidism, even with surgical repair, is associated with increased risk for testicular cancer.
A 16 year old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting. She hasn't missed any doses and uses no other medication. Which of the following is appropriate?
- Modifying use
- Double dosing for 2 days
- Changing to Ortho-Novum 1/35
D. Providing reassurance - CORRECT ANSWER: D. Providing reassurance
A 17 year old female is suspected of having polycystic ovary syndrome. In addition to
testosterone, the most appropriate diagnostic tests to order would be:
- BUN, creatinine, electrolytes, and dehydroepiandrosterone(DHEA)
- CBC, BUN, creatinine, and estrone
- Fasting blood sugar (FBS), complete blood count (CBC), BUN, and sex hormone
- Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), prolactin, and thyroid-
binding globulin
stimulating hormone (TSH) - CORRECT ANSWER: D. FSH, LH, TSH
A 17 year old femlae has never had her menses. She is at Tanner stage III of sexual development. Her physical exam in completely normal, and her weight is appropriate for her age and height. What is the most likely diagnosis?
- Ovarian dysgenesis
- Dysmenorrhea
- Primary amenorrhea
D. Secondary amenorrhea - CORRECT ANSWER: C. Primary amenorrhea
A 20 yo male presents with a 1 month history of a " bump on my testicle" He reports being sexually active, frequent episodes of unprotected intercourse with multiple partners. Which condition should be suspected?
- Cancer of the testicles
- Torsion of the testicles
- Acute epididymitis
D. Gonorrhea - CORRECT ANSWER: A. Cancer of the testicles
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A 21 yo college student presents to the sudent health center with copious, markedly
purulent discharge from her left eye. The nurse practitioner should suspect: -
CORRECT ANSWER: gonococcal conjunctivitis.
A purulent and copious discharge should alert the nurse practitioner to the likely possibility of gonococcal or chlamydial conjunctivitis. Noth require systemic anitbiotic treatment and immediate referral to an opthalmologist for evaluation.
A 21-yo patient presents with abdominal guarding, rigid abdominal musculature, rebound tenderness at McBurney's point, and leukocytosis. What is the most likely
diagnosis? - CORRECT ANSWER: Appendicitis.
McBurney's point is the RLQ abdominal landmark for the appendix. Rigid abdominal musculature, rebound tenderness, and positive psoas sign (inflamed psoas muscle), indicates inflammation of the peritoneum. Cholecystitis presents with RUQ pain and positive Murphy's inspriatory arrest. Ilcerative colitis presents with LLQ pain. Pain associated with pancreatitis is typically in the epigastric region.
A 24 yo female taking an oral contraceptive has missed her last 2 pills. What should the nurse practitioner advise her to do to minimize her risk of pregnancy? - CORRECT ANSWER: Double today's dose and tomorrow's dose and use a barrier method for the rest of the month.If 2 mills are missed on consecutive days, the next 2 days' doseages should be doubled and a barrier method recommended for the remainder of the cycle.
A 25 yo female has a history of frequent candidal vaginal infections in the past year.She is in a monogamous sexual relationship and uses and IUD for contraception. Of the following, which is the most likely underlying conidition predisposing her to recurring
candidal vaginitis? - CORRECT ANSWER: Diabetes.
A common underlying cause of frequent infections is diabetes mellitus. Pregnancy increases the incidence of candidiasis, but is unlikely a factor with this patient.
A 25-year old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated with movement. The patient reports that he participated in extensive house painting 24 hours prior to the onset of pain. He denies any trauma.Passive ROM is intact. No redness or ecchymosis is present. What is the next step that should be taken in order to make a diagnosis?
- Palpate structures around the shoulder
- Obtain an MRI to evaluate the shoulder
- Order an Xray of the shoulder
D. Request an EMG - CORRECT ANSWER: A. Palpate the structures around the
shoulder
A 25-yo female patient presents for a routine well-women exam. On physical exam, the NP notes a scant nipple discharge, absence of palpable mass, and absence of lymph node enlargement. What is the most likely diagnosis? - CORRECT ANSWER: Itraductal papilloma.
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