Mixed Deck — All NP Topics Flashcards

Which medication is considered first-line treatment for uncomplicated urinary tract infections in non-pregnant women?

Answer: Nitrofurantoin 100mg BID x 5 days

Nitrofurantoin for 5 days is first-line for uncomplicated UTI due to high efficacy, low resistance rates, and minimal collateral damage to gut flora.

When initiating buprenorphine/naloxone (Suboxone) for opioid use disorder, the NP should begin induction only after the patient is in:

Answer: Mild to moderate opioid withdrawal (COWS score ≥ 8–12)

Starting buprenorphine before moderate withdrawal risks precipitating acute withdrawal; a COWS score of 8–12 indicates the patient is ready for induction.

Why is documentation important in NP risk management?

Answer: It creates an audit trail, supports decision-making, and demonstrates due diligence

This is fundamental to Nurse Practitioner practice. It creates an audit trail, supports decision-making, and demonstrates due diligence represents the professional standard for risk management in the NP certification framework.

A 70-year-old patient presents with a new murmur described as a harsh systolic ejection murmur radiating to the carotids, with exertional syncope and dyspnea. The most likely valvular pathology is:

Answer: Aortic stenosis

The classic triad of angina, syncope, and heart failure with a crescendo-decrescendo systolic murmur radiating to the neck is the hallmark of severe aortic stenosis.

When assessing a geriatric patient for frailty in the acute care setting, which tool is most validated and widely used?

Answer: Clinical Frailty Scale (CFS)

The Clinical Frailty Scale is a 9-point scale validated for use in acute care settings to predict adverse outcomes including mortality, institutionalization, and prolonged hospital stay.

What is the purpose of regular risk reviews in Nurse Practitioner practice?

Answer: To identify new risks, evaluate control effectiveness, and update mitigation strategies

This is fundamental to Nurse Practitioner practice. To identify new risks, evaluate control effectiveness, and update mitigation strategies represents the professional standard for risk management in the NP certification framework.

The NP provides anticipatory guidance about vaccine-preventable disease. Which vaccine is recommended annually for all patients ≥ 6 months of age in the US?

Answer: Influenza vaccine

The CDC recommends annual influenza vaccination for everyone 6 months and older because influenza strains change yearly, requiring updated vaccine formulations.

When using the PICO framework, what does the 'C' component represent?

Answer: Comparison or control intervention

In PICO, 'C' stands for Comparison, the alternative intervention or control against which the intervention is measured.

A patient with capacity refuses a recommended blood transfusion for religious reasons. The NP should:

Answer: Respect the refusal, document it thoroughly, and ensure informed refusal is signed

A competent adult has the legal and ethical right to refuse any medical treatment, including life-saving interventions; the NP must document the informed refusal process.

A nurse practitioner is seeing a 28-year-old female patient who discloses intimate partner violence. Which action is the HIGHEST priority?

Answer: Assess immediate safety and provide referrals to local resources

The immediate priority in IPV disclosure is assessing the patient's current safety and connecting her with resources; mandatory reporting of adult IPV is NOT required in most US states.

A patient asks the NP about primary prevention of cardiovascular disease. Which lifestyle intervention has the strongest evidence for reducing cardiovascular mortality?

Answer: Regular aerobic exercise 150 minutes per week

Regular moderate-intensity aerobic exercise for at least 150 minutes per week is one of the most consistently evidence-supported interventions for reducing cardiovascular morbidity and mortality.

Under HIPAA's Minimum Necessary Standard, when an NP accesses the EHR, which practice is MOST appropriate?

Answer: Access only the patient information needed to perform a specific, authorized task

The Minimum Necessary Standard requires limiting PHI access to only what is needed for the immediate, authorized purpose.

When performing a skin cancer risk assessment, which patient characteristic carries the HIGHEST independent risk for melanoma?

Answer: Use of indoor tanning beds before age 35

Indoor tanning bed use before age 35 increases melanoma risk by 59–75% and is classified as a Group 1 carcinogen by the IARC.

A male patient, age 6, who is highly active and frequently disturbs the pediatric unit by banging on the bed, calling out, tearing things apart, and causing commotion. The ideal answer is probably:

Answer: plan regular periods of active play throughout the day

A 6-year-old is naturally active and needs outlets for their energy, even in a hospital setting. Planning regular periods of active play addresses the child's developmental needs and can help manage disruptive behavior by providing appropriate channels for physical activity and stimulation. This approach promotes a more positive hospital experience and reduces the likelihood of the child acting out due to boredom or confinement.

Which genetic risk factor assessment should be prioritized for a 35-year-old woman whose mother and maternal aunt both had breast cancer diagnosed before age 50?

Answer: Refer directly to genetic counseling for hereditary cancer evaluation

A strong family history suggesting hereditary breast cancer syndrome warrants direct referral to genetic counseling for comprehensive risk assessment and appropriate BRCA testing.

A woman schedules a visit with the clinic to talk about the resources available to care for her elderly mother, who has terminal cancer and has had multiple strokes. What kind of recommendation or consultation would be appropriate for this client?

Answer: Hospice

Hospice care is appropriate for individuals with a terminal illness and a prognosis of six months or less, focusing on comfort, pain management, and quality of life rather than curative treatment. Given the mother's terminal cancer and multiple strokes, hospice services would provide comprehensive support for both the patient and her family during this difficult time, addressing physical, emotional, and spiritual needs.

When managing acute ischemic stroke, what is the maximum time window for IV alteplase administration from symptom onset in eligible patients?

Answer: 4.5 hours

IV alteplase can be administered up to 4.5 hours from symptom onset in carefully selected patients per AHA/ASA guidelines, though benefit is greatest when given earlier.

Which of the following scenarios describes a potential violation of the False Claims Act?

Answer: Upcoding a patient visit from level 3 to level 5 without documentation to support the higher level

Upcoding—billing for a higher level of service than was actually provided or documented—constitutes healthcare fraud under the False Claims Act.

A study reports a relative risk of 0.60 for a new antihypertensive drug. How should an NP interpret this finding?

Answer: The treatment group had 40% lower risk of the outcome than the control group

A relative risk of 0.60 means the treatment group's risk is 60% of the control group's risk, representing a 40% relative risk reduction.

A patient with a T-6 spinal cord injury lays flat on their back in bed when all of a sudden, they have blurred vision, a terrible headache, a piloerection with pallor below the lesion and flushing above it, as well as noticeably raised blood pressure of 280/160. The first thing to do is:

Answer: Elevate the head of the bed to 45°

The patient's symptoms are classic signs of autonomic dysreflexia (AD), a life-threatening emergency in individuals with spinal cord injuries at T6 or above. The immediate priority is to elevate the head of the bed to 45 degrees. This helps to reduce cerebral blood pressure and prevent complications like stroke or intracranial hemorrhage, while simultaneously searching for and alleviating the noxious stimulus causing the AD.