NP Certification Q&A

A 50-year-old woman presents for follow-up on recent lab tests obtained at a health maintenance visit. She reports feeling well and denies fatigue, weight changes, constipation, cold intolerance, palpitations, or changes in mood. She was recently diagnosed with subclinical hypothyroidism. 
Which of the following would be her expected lab results?
A. TSH of 8.6, elevated free T4 of 14, which is normal.
B. TSH of less than 0.15, undetectable. Free T4 of 79, markedly elevated.
C. TSH of 24, elevated. A free T4 of three, markedly reduced.
D. TSH of 1.8, which is normal and a free T4 of 14, also normal.
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A 29-year-old otherwise healthy adult presents with a five-day history of nasal congestion, clear to white rhinorrhea, sore throat, and dry cough. She also denies dyspnea, pleuritic chest pain, GI upset, or fever. The patient is in no acute distress. Vital signs are temperature 99.2 Fahrenheit or 37.3 degrees centigrade. Respiratory rate is 16. O2 sat is 98 % on room air. Physical exam reveals mild pharyngeal erythema without exudate, no lymphadenopathy and tympanic membranes within normal limits. Lung resam is unremarkable except for occasional cough. The nurse practitioner diagnoses a viral URI or a common cold. The patient states, “I have trip coming up in five days, and I'm really worried that I might have the start of a sinus infection or pneumonia or a strep throat.” 
The NP considers which of the following in addressing the patient's concerns? 
A. if you start to cough up phlegm within the next day or so, this could indicate the start of a pneumonia
B. If your nasal discharge turns to green or dark yellow, this usually indicates that an antibiotic is needed
C. your cough could persist for a couple of weeks, which is quite common in a viral respiratory tract infection
D. if your sore throat persists for two to three more days, it means that a strep infection is starting
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A six-month, two-week-old infant who was born at 40.5 weeks gestation after an uneventful pregnancy is brought in for a well child visit. His parents mentioned, “his older sister was a really different baby. I think he's not quite where she was in his development at this age.” Which of the following would not be a red flag requiring further evaluation? 
A. Inability to roll in either direction
B. Unable to transfer objects hand to hand
C. Reaches for objects with one hand
D. Ability to sit briefly without support
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Sarah, a healthy infant born at 40.5 weeks gestation after an uncomplicated pregnancy, is brought in for a four-month well child visit. Parents report the infant is feeding well, smiling frequently, and becoming more interactive with family members. 
Which of the following is most consistent with a normal developmental exam for an infant of this age?
A. Rolls back to abdomen and transfers objects hand to hand
B. brings hands together and laughs out loud
C. Lifts head briefly when prone and startles to loud sounds
D. Increase babbling and sits without support
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A 24-year-old woman presents for a well-adult visit. Her health history includes the diagnosis of mitral valve prolapse without significant mitral regurgitation. She is feeling well, has no chief complaint, and denies activity intolerance, stating she plays tennis or pickleball for about one hour three to four times a week. Her only medication is an oral combined hormonal contraceptive and reports being pleased with her contraceptive method. She states that she read online that “I know I have a heart murmur and I'm worried about whether the birth control pill is safe for me.” The nurse practitioner considers the following when advising this patient
A. she should switch to a progestin only contraceptive method
B. if no other contraindications are present, she can continue to use combined hormonal contraception
C. in this clinical scenario, barrier contraceptive method is advised
D. she should be referred to cardiology for advice on contraceptive methods
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YouTube: https://www.youtube.com/watch?v=fkJkZLA1BM8&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=144
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