Family Nurse Practitioner Test Clinical Assessment 2 — Questions and Answers
Question 1: A patient has pitting edema graded 3+. How deep is the pit and how long does it take to rebound?
- 5–6 mm pit, rebounds in >1 minute (Correct answer)
- 1–2 mm pit, rebounds quickly
- 3–4 mm pit, rebounds in 10–15 seconds
- 7+ mm pit, permanent indentation
Correct answer: 5–6 mm pit, rebounds in >1 minute
Grade 3+ pitting edema produces a 5–6 mm deep pit that takes more than one minute to rebound.
Question 2: When auscultating the abdomen, the FNP hears a bruit over the renal artery. This finding suggests:
- Renal artery stenosis (Correct answer)
- Bowel obstruction
- Normal peristalsis
- Aortic aneurysm
Correct answer: Renal artery stenosis
A renal artery bruit indicates turbulent blood flow, most commonly from renal artery stenosis, a correctable cause of secondary hypertension.
Question 3: The FNP notes a S4 heart sound in an older patient with hypertension. This sound occurs because of:
- Reduced ventricular compliance requiring forceful atrial contraction (Correct answer)
- Rapid ventricular filling in early diastole
- Mitral valve prolapse
- Aortic stenosis turbulence
Correct answer: Reduced ventricular compliance requiring forceful atrial contraction
An S4 results from atrial contraction against a stiff, noncompliant ventricle, commonly seen in hypertensive heart disease.
Question 4: A positive Phalen's test reproduces which symptom and in which condition?
- Paresthesias in the first three fingers; carpal tunnel syndrome (Correct answer)
- Wrist pain with gripping; De Quervain's tenosynovitis
- Lateral elbow pain; tennis elbow
- Numbness of the fifth finger; cubital tunnel syndrome
Correct answer: Paresthesias in the first three fingers; carpal tunnel syndrome
Phalen's test reproduces median nerve paresthesias in the thumb, index, and middle fingers, confirming carpal tunnel syndrome.
Question 5: During a thyroid exam, the FNP asks the patient to swallow. This maneuver is done to:
- Distinguish thyroid tissue from other neck masses by observing upward movement (Correct answer)
- Assess vocal cord function
- Identify lymphadenopathy
- Evaluate carotid artery pulsation
Correct answer: Distinguish thyroid tissue from other neck masses by observing upward movement
Thyroid tissue is attached to the trachea and moves upward with swallowing, distinguishing it from fixed neck masses.
Question 6: A patient reports pain on palpation of the anatomical snuffbox. The FNP should FIRST suspect:
- Scaphoid fracture (Correct answer)
- Wrist sprain
- De Quervain's tenosynovitis
- Colles' fracture
Correct answer: Scaphoid fracture
Anatomical snuffbox tenderness after wrist injury is the hallmark sign of scaphoid fracture, which requires imaging even if initial X-rays are negative.
Family Nurse Practitioner Test Clinical Assessment 2
A patient has pitting edema graded 3+.
How deep is the pit and how long does it take to rebound?