Expiration Date: December 31, 2011. No CE contact hours (CH) will be given after this date.
This continuing education module should be taken ONLY by those who have purchased the Adult Nurse Practitioner Review & Resource Manual, 3rd Edition. During the process of purchasing this CE module, you will be asked to input the proof of purchase code which can be obtained by sending an e-mail to revmanuals@ana.org.
The actual questions that will be on the test have been posted below.
When you purchase the CE module, you will be issued a password which will allow you to access all CE modules purchased on the NursingWorld Web site. This password is NOT to be confused with the proof of purchase code you received when you purchased the manual. It is important that you remember this password, as you MUST use it if you wish to log out of the system and return at a later time to take the test or to print duplicates of your certificate of completion.
IMPORTANT NOTE: The test for Contact Hours for Cardiac Vascular Review and Resource Manual contains 25 questions. You may find that you are not able to complete the entire test in one sitting. If this is the case, simply click on "Grade My Test" at the bottom of the test page even though you have not yet completed the test. This will allow the system to store your test for your return visit.
When you wish to return, click on "Log Back In" from the CE home page menu and input the CE password you were issued when you first registered for ANA's online CE. Again, do not input the purchase code you were issued as proof of purchase of the manual. Once you are logged back into the system, you will see a list of the ISMs you have completed and ones that are incomplete. Click on "Take Test" next to any incomplete ISM and you will be told how many questions you have completed and how many are left to complete.
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Test Questions
1. The nurse practitioner is providing education for a male patient newly diagnosed with coronary artery disease. The patient smokes two packs of cigarettes a day. According to the transtheoretical model of change, the first step in smoking cessation will be characterized by which stage of change?
a. Action
b. Contemplation
c. Rrecontemplation
d. Preparation
2. Who among the following patients is a candidate for weight loss interventions?
a. An obese patient who just completed cardiac rehabilitation
b. A patient being treated for uncontrolled hypertension
c. A patient who has just been discharged after abdominal surgery
d.Any patient with a body mass index (BMI) over 30
3. Which of the following best describes current exercise recommendations to promote and maintain health?
a. A combination of moderate and intense activity may be implemented; all adults should include resistance training 2 days a week
b. All adults over the age of 40 should have an exercise stress test before beginning an exercise program
c. Exercise should be implemented all or most days of the week
d. Moderately intense exercise is more beneficial than vigorously intense exercise
4. Cervical cancer screening should be conducted
a. Annually
b. Annually in patients with a family history
c. Every other year following hysterectomy
d. Every three years.
5. The one clinical feature not associated with conjunctivitis is
a. Bilateral presentation
b. Conjunctival injection
c. Eye pain
d. Gritty sensation in the eyes
6. A 30-year-old female presents complaining of acute, unilateral left eye pain. The nurse practitioner appreciates that the left pupil is fixed and non-reactive at 6 mm. The eye is also erythematous. The nurse practitioner knows that this must be referred immediately to ophthalmology because the leading differential diagnosis is:
a. Dacrocystitis
b. Gonococcal conjunctivitis
c. Narrow angle glaucoma
d. Uveitis
7. In a sensorineural hearing loss, the nurse practitioner expects which abnormal finding?
a. The Weber test is normal
b. The Weber test lateralizes to the affected side
c. The Weber test lateralizes to the unaffected side
d. The Weber test is prolonged
8. Which of the following is the cause of 90% of cases of pharyngitis?
a. Allergies
b. Cigarette smoking
c. Gastroesophageal reflux (GERD)
d. Viral infection
9. The most significant, non-modifiable risk factor for coronary artery disease (CAD) is
a. Age
b. Cigarette smoking
c. Dyslipidemia
d. Family history
10. During a routine physical examination, the nurse practitioner appreciates a grade III/VI diastolic murmur at the second intercostal space, right sternal border. This is most likely
a. Aortic regurgitation
b. A physiologic murmur
c. Pulmonic stenosis
d. Tricuspid stenosis
11. With respect to aortic stenosis (AS), the nurse practitioner knows that
a. 10% to 20% of patients will develop hemodynamically significant disease
b. Females are affected twice as often as males
c. It is a common consequence of rheumatic heart disease
d. It occurs in 60% of persons over 70 years old
12. A diagnosis of chronic obstructive pulmonary disease (COPD) must include
a. Chronic cough
b. Chronic mucus production
c. FEV1/FVC ratio of < 0.7
d. FEV1 < 80% predicted
13. CURB-65 is:
a. An acronym for the most common adverse drug reactions in the over-65 population
b. Most accurate in a normotensive patient
c. Not appropriate for use in the elderly population
d. A scale used to assess the need for hospital admission in patients with pneumonia
14. The primary feature that distinguishes gastroesophageal reflux (GERD) from other gatrointestinal (GI) conditions causing pyrosis or dyspepsia is the
a. Fact that discomfort is relieved by ingesting food/liquids
b. Increased likelihood in obese patients
c. Need for endoscopy to establish diagnosis
d. Presence of extraesophageal symptoms
15. Disease-modifying drugs are the mainstay of pharmacologic therapy for rheumatoid arthritis. The nurse practitioner knows that tumor necrosis factor inhibitors must be discontinued if the patient develops
a. Gastrointestinal bleeding
b. Systemic infection
c. Worsening joint deformity
d. Worsening joint pain
16. Low back pain is a common complaint in the primary care setting. The nurse practitioner knows that the most important component of evaluating back pain is
a. An MRI
b. A physical examination to rule out neurological disease
c. Radiographic assessment
d. A thorough history
17. A 38-year-old male presents with acute onset of a painful swelling just under the left knee. The swelling is fluctuant and tender to the touch. There is some surrounding erythema. No loss of range of motion is appreciated. The nurse practitioner knows that treatment will probably include:
a. Compression therapy
b. Fluid aspiration
c. RICE
d. Surgical removal
18. Urinary incontinence characterized by leaking immediately following a strong urge to void is most likely
a. Functional incontinence
b. Stress incontinence
c. Transient incontinence
d. Urge incontinence
19. Which of the following is not true with respect to Pap testing?
a. It is not necessary in women who have never had sexual relations
b. Low grade lesions are often overdiagnosed
c. There is no recommendation for routine screening over age 60
d. They may be performed every 2 to 3 years in women with normal Paps
20. When a patient on oral contraception complains of breakthrough bleeding that occurs consistently during the first half of the menstrual cycle, the nurse practitioner should
a. Discontinue oral contraception and purse other methods
b. Increase the estrogen component of the pill
c. Increase the progestin component of the pill
d. Maintain the current regimen but monitor hemoglobin
21. The patient describes an acute onset of a macular rash on the trunk. The rash is characterized by fawn colored plaques and a herald patch. The nurse practitioner knows that further evaluation should include
a. A complete blood count
b. An erythrocyte sedimentation rate
c. A serum PRP
d. Patch testing of the lesions
22. The nurse practitioner is managing a patient with type 2 diabetes mellitus on metformin, 500 mg bid. Routine assessment of HgbA1c reveals a level of 5.8%. Appropriate intervention includes
a. Adding a sulfonylurea
b. Decreasing the metformin to once daily dosing
c. Increasing the metformin to 1000 mg bid
d. No pharmacologic changes at this time
23. In a patient with anemia, the following complete blood count (CBC) suggests which type of anemia? Hgb of 9.6, Hc6 29%, MCV 74 cells/uL, RDW 17%.
a. Folic acid deficiency
b. Iron deficiency anemia
c. Pernicious anemia
d. Thalassemia
24. Which form of leukemia is characterized by the Philadelphia chromosome?
a. Acute lymphobloastic leukemia (ALL)
b. Acute myelogenous leukemia (AML)
c. Chronic lymphocytic leukemia (CLL)
d. Chronic myelogenous leukemia (CML)
25. Reasons to change antiretroviral therapy for patients with HIV include
a. The CD4 count is 350 cells
b. Fever due to immune reconstitution syndrome
c. The patient develops opportunistic infection
d. Viral load greater than 400 cells after 24 weeks of therapy