Family Nurse Practitioner Test Patient Management 3

Question 1

An elderly patient is found to have a serum sodium of 128 mEq/L with euvolemia. Which is the MOST appropriate initial management?

Accepted Answer

Fluid restriction and identify underlying cause (e.g., SIADH)

Answer

Rapid correction with 3% hypertonic saline

Answer

Administer normal saline at 200 mL/hr

Answer

Initiate furosemide diuresis

Question 2

A 4-year-old is brought in by parents for fever and appears non-toxic. On exam the FNP notes a petechial rash that does NOT blanch with pressure. The PRIORITY action is:

Accepted Answer

Emergency transfer to the ED for suspected meningococcemia

Answer

Prescribe oral amoxicillin and observe at home

Answer

Order CBC and CMP and see results next day

Answer

Diagnose viral exanthem and reassure parents

Question 3

A patient with bipolar I disorder is started on lithium. Which parameter requires the MOST vigilant monitoring?

Accepted Answer

Serum lithium level, renal function (creatinine), and thyroid function

Answer

Liver function tests

Answer

CBC weekly for the first month

Answer

Fasting lipid panel monthly

Question 4

The FNP is counseling a postmenopausal woman on hormone therapy (HT). Which combination is preferred for a woman WITH a uterus?

Accepted Answer

Estrogen plus progestogen (combined HT)

Answer

Estrogen alone

Answer

Progestogen alone

Answer

Testosterone supplementation

Question 5

A patient with chronic kidney disease and secondary hyperparathyroidism has low calcium and elevated phosphorus. The FNP should FIRST address:

Accepted Answer

Phosphorus restriction and phosphate binders

Answer

High-dose vitamin D supplementation alone

Answer

Calcium supplementation alone

Answer

Parathyroidectomy

Question 6

A patient newly diagnosed with rheumatoid arthritis has active synovitis. Per ACR guidelines, which is the FIRST-LINE disease-modifying agent (DMARD)?

Accepted Answer

Methotrexate

Answer

Prednisone alone

Answer

NSAIDs alone

Answer

Hydroxychloroquine alone