Family Nurse Practitioner Test Family Nurse Practitioner Skill 5 — Questions and Answers
Question 1: A 10-year-old child is brought in after a bee sting. She develops urticaria, throat tightness, and hypotension. What is the first-line treatment?
- Diphenhydramine 50 mg IV
- Epinephrine 0.3 mg IM in the lateral thigh (Correct answer)
- Methylprednisolone 125 mg IV
- Albuterol nebulizer treatment
Correct answer: Epinephrine 0.3 mg IM in the lateral thigh
Intramuscular epinephrine in the anterolateral thigh is the first and most critical treatment for anaphylaxis due to its rapid onset and life-saving effect.
Question 2: Which finding on urinalysis is most specific for a urinary tract infection caused by E. coli?
- Presence of protein
- Positive leukocyte esterase and nitrites with WBC casts (Correct answer)
- Hematuria alone
- Specific gravity > 1.020
Correct answer: Positive leukocyte esterase and nitrites with WBC casts
Positive leukocyte esterase (indicating WBCs) combined with positive nitrites (indicating gram-negative bacteria like E. coli) is most specific for bacterial UTI.
Question 3: A 68-year-old male with a history of BPH presents with acute urinary retention. What is the immediate management?
- Start tamsulosin and reassess in 48 hours
- Insert a urinary catheter to decompress the bladder (Correct answer)
- Order a renal ultrasound before any intervention
- Administer furosemide to promote urination
Correct answer: Insert a urinary catheter to decompress the bladder
Acute urinary retention requires immediate bladder decompression via urethral catheterization to prevent renal damage and relieve pain.
Question 4: A 40-year-old woman is newly diagnosed with major depressive disorder and has no prior psychiatric history. Which class of medication is the first-line pharmacologic treatment?
- Tricyclic antidepressants (TCAs)
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Monoamine oxidase inhibitors (MAOIs)
- Benzodiazepines
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are first-line for major depressive disorder due to their favorable side effect profile, efficacy, and safety in overdose compared to older antidepressants.
Question 5: A school-age child presents with an intensely pruritic rash with linear burrows between the fingers and on the wrists, worse at night. What is the treatment?
- Oral antihistamine for 2 weeks
- Topical permethrin 5% cream applied from neck to toes and washed off after 8–14 hours (Correct answer)
- Topical hydrocortisone cream
- Oral prednisone burst
Correct answer: Topical permethrin 5% cream applied from neck to toes and washed off after 8–14 hours
Scabies is treated with permethrin 5% cream applied to the entire body surface from neck down and left on for 8–14 hours; all household members should be treated simultaneously.
Question 6: Which of the following is an absolute contraindication to the use of combined oral contraceptive pills (COCPs)?
- Age over 35 with no smoking history
- History of migraines without aura
- Personal history of DVT or pulmonary embolism (Correct answer)
- Mild controlled hypertension
Correct answer: Personal history of DVT or pulmonary embolism
A personal history of venous thromboembolism (DVT/PE) is an absolute contraindication to estrogen-containing contraceptives due to markedly elevated clot risk.
Question 7: A 55-year-old male with known coronary artery disease presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea. ECG shows ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
- Left anterior descending (LAD) artery
- Right coronary artery (RCA) (Correct answer)
- Left circumflex artery
- Left main coronary artery
Correct answer: Right coronary artery (RCA)
ST elevations in leads II, III, and aVF indicate an inferior STEMI, most commonly caused by occlusion of the right coronary artery.
Family Nurse Practitioner Test Family Nurse Practitioner Skill 5
A 10-year-old child is brought in after a bee sting.
She develops urticaria, throat tightness, and hypotension.
What is the first-line treatment?