Practice Test GeeksNP - Nurse Practitioner Practice Test
← All NP Flashcard Decks

Case Studies & Practical Application Flashcards

7 cards from real NP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Case Studies & Practical Application flashcards as text

  1. A 58-year-old male with type 2 diabetes presents with a painless, non-healing ulcer on the plantar aspect of his right foot for 3 weeks. ABI is 0.95, HbA1c is 10.2%, and the wound base is pink with no purulence. Which is the most appropriate next step?

    Answer: Optimize glycemic control and begin offloading with a total contact cast

    Neuropathic diabetic foot ulcers without infection require offloading (total contact cast is gold standard) and glycemic optimization as first-line management.

  2. A 34-year-old woman at 28 weeks gestation presents with sudden-onset right upper quadrant pain, nausea, and vomiting. BP is 158/102 mmHg, platelets 88,000/μL, AST 210 U/L. What is the most likely diagnosis?

    Answer: HELLP syndrome

    HELLP syndrome presents with hemolysis, elevated liver enzymes, and low platelets in the setting of preeclampsia, often with RUQ pain.

  3. A 72-year-old woman is started on lisinopril for heart failure with reduced ejection fraction. Two weeks later she returns with a persistent dry cough. What is the best management?

    Answer: Switch to an ARB such as losartan

    ACE inhibitor-induced cough is a class effect due to bradykinin accumulation; switching to an ARB provides equivalent HFrEF benefit without this side effect.

  4. A 45-year-old man presents with sudden severe headache described as 'the worst of my life,' neck stiffness, and photophobia. CT head is negative. What must be done next?

    Answer: Perform lumbar puncture to evaluate for xanthochromia

    A thunderclap headache with negative CT requires lumbar puncture to rule out subarachnoid hemorrhage, as CT misses up to 5% of cases.

  5. A 62-year-old woman with COPD GOLD stage 3 is on dual bronchodilator therapy. She has had 2 exacerbations requiring oral steroids in the past year and her eosinophil count is 320 cells/μL. What is the best next step in therapy?

    Answer: Add an inhaled corticosteroid (ICS) to her regimen

    GOLD guidelines recommend adding ICS to LABA/LAMA in COPD patients with frequent exacerbations and elevated eosinophils (≥300 cells/μL).

  6. An 8-year-old boy is brought in for recurrent ear infections — his fourth episode in 12 months. Each time he improves with amoxicillin. Today he is afebrile with mild erythema of the right tympanic membrane. What is the most appropriate recommendation?

    Answer: Refer to otolaryngology for tympanostomy tube evaluation

    Four or more acute otitis media episodes in 12 months (or 3 in 6 months) meets criteria for ENT referral for tympanostomy tube consideration.

  7. A 28-year-old woman with no significant history presents with a 3-week course of fatigue, pharyngitis, posterior cervical lymphadenopathy, and splenomegaly. Monospot test is negative. What is the next best diagnostic step?

    Answer: Order EBV-specific antibodies (VCA IgM, EA, EBNA)

    Monospot has up to 25% false-negative rate, especially early in illness; EBV-specific serology (VCA IgM) is more sensitive for confirming infectious mononucleosis.