Free Family Nurse Practitioner Skill Questions and Answers

Question 1

Congestive heart failure has recently been diagnosed in Greg, age 68. (CHF). Which medicine should be stopped for him?

Accepted Answer

Nifedipine (Procardia XL) for long-term management of his chronic stable angina.

Answer

Nifedipine, particularly immediate-release formulations, is a dihydropyridine calcium channel blocker that can cause peripheral vasodilation and reflex tachycardia, which can worsen heart failure symptoms or exacerbate myocardial ischemia. While extended-release forms like Procardia XL are safer, non-dihydropyridine CCBs or other anti-anginal agents are generally preferred in CHF patients if a CCB is needed. Beta-blockers (if stable CHF), ACE inhibitors, and diuretics are often beneficial in CHF management, making nifedipine a less suitable choice.

Question 2

What statement about mitral regurgitation is correct?

Accepted Answer

It may be noted as a holosystolic murmur.

Answer

Mitral regurgitation (MR) is the backflow of blood from the left ventricle into the left atrium during systole due to incomplete closure of the mitral valve. This abnormal flow creates a characteristic heart sound known as a holosystolic (or pansystolic) murmur. This murmur is typically heard throughout the entire systole, distinguishing it from other types of murmurs.

Question 3

Gary, a healthy 16-year-old kid, is getting a sports physical examination. Which question from the past should the doctor ask Kevin or his parent?

Accepted Answer

Did anyone in your family ever have sudden cardiac death?

Answer

When conducting a sports physical for an adolescent, it is crucial to screen for conditions that could lead to sudden cardiac death (SCD) during physical exertion. A family history of sudden cardiac death, especially in young individuals, can indicate underlying genetic cardiac conditions like hypertrophic cardiomyopathy or long QT syndrome. These conditions are significant risks for athletes and require further investigation.

Question 4

Which patient would you recommend getting the HPV vaccine for?

Accepted Answer

Sally, age 17, who had a baby 6 months ago and is breastfeeding.

Answer

The HPV vaccine is recommended for individuals up to age 26, and it can be safely administered to breastfeeding women. Pregnancy is a contraindication for receiving the vaccine, and while the vaccine can be started as early as age 9, a 7-year-old is generally too young for the standard recommendation. A yeast allergy is not a contraindication for the HPV vaccine.

Question 5

Angelo, age 35, says he recently returned from a business trip and feels strange pressure in his ear, therefore he believes he has an ear infection. Your barotrauma diagnosis. What will you do next?

Accepted Answer

Prescribe nasal steroids and oral decongestants.

Answer

Barotrauma, or "ear pressure," often results from pressure differences between the middle ear and the external environment, commonly experienced after air travel or diving. This can cause Eustachian tube dysfunction. Nasal steroids and oral decongestants help reduce inflammation and open the Eustachian tubes, allowing for pressure equalization and symptom relief without the need for antibiotics unless there's evidence of bacterial infection.

Family Nurse Practitioner Test Practice Test

Family Nurse Practitioner Test Practice Test

Free Family Nurse Practitioner Skill Questions and Answers