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

Euvolemic hyponatremia (SIADH) is managed with fluid restriction and identifying the underlying cause; rapid correction risks osmotic demyelination syndrome.

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

Non-blanching petechiae with fever can indicate meningococcemia (Neisseria meningitidis), a rapidly fatal condition requiring immediate emergency evaluation and IV antibiotics.

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

Lithium has a narrow therapeutic index, is renally excreted, and causes hypothyroidism; regular serum levels, renal function, and thyroid function tests are mandatory.

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

Women with an intact uterus must receive progestogen with estrogen to prevent unopposed estrogen stimulation causing endometrial hyperplasia and cancer.

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

Hyperphosphatemia drives secondary hyperparathyroidism in CKD; dietary phosphorus restriction combined with phosphate binders is the first-line approach.

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Patient Management 3