Family Nurse Practitioner Test Patient Management 2

Question 1

A 14-year-old patient discloses substance use during a confidential visit. Under HIPAA and most state laws, the FNP should FIRST:

Accepted Answer

Provide counseling, assess for dependence, and determine if the minor is in immediate danger before breaching confidentiality

Answer

Immediately notify parents

Answer

Report to child protective services

Answer

Refer to psychiatry without disclosure to parents

Question 2

The FNP is counseling a 25-year-old female on combined oral contraceptive pills (COCs). Which absolute contraindication (WHOMEC Category 4) should be screened for?

Accepted Answer

History of DVT or pulmonary embolism

Answer

Irregular menstrual cycles

Answer

Smoking fewer than 15 cigarettes per day under age 35

Answer

Controlled hypertension

Question 3

A patient with CKD stage 3 (eGFR 35 mL/min) and diabetes has a blood pressure of 142/88 mmHg. The PREFERRED antihypertensive agent is:

Accepted Answer

ACE inhibitor or ARB for renoprotection

Answer

Thiazide diuretic

Answer

Calcium channel blocker only

Answer

Beta-blocker only

Question 4

A patient with alcohol use disorder requires treatment for acute alcohol withdrawal. Which medication class is FIRST-LINE?

Accepted Answer

Benzodiazepines (e.g., lorazepam)

Answer

Antipsychotics (e.g., haloperidol)

Answer

Beta-blockers (e.g., propranolol)

Answer

Opioids

Question 5

The FNP is conducting a sports physical for a 16-year-old. Which finding warrants DISQUALIFICATION from contact sports?

Accepted Answer

Single functional kidney

Answer

Well-controlled asthma

Answer

History of simple concussion cleared by neurology

Answer

Mild exercise-induced bronchospasm treated with albuterol

Question 6

A patient in the third trimester of pregnancy presents with severe headache, visual changes, and BP of 162/110. The FNP's IMMEDIATE action is:

Accepted Answer

Emergency transfer to the hospital for evaluation of severe preeclampsia/eclampsia

Answer

Start oral hydralazine and monitor in office

Answer

Recheck BP in 4 hours

Answer

Advise bedrest and low-sodium diet