DRNP-6531 – Module 1 – Advanced Nursing Practice Competencies, Integumentary, and HEENT Conditions

In this exercise, you will complete a 10- question Knowledge Check to gauge your understanding of this module’s content. Please note that this is a formative practice to help you better prepare for your Midterm and Final Exam as well as your Nurse Practitioner (NP) certification exam. The questions in this Knowledge Check are related to the topics from Weeks 1, 2, and 3 Topics include:

Nursing competencies

Billing and coding

Integumentary conditions

HEENT conditions

It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

Complete and submit your Knowledge Check.

Question 1

A 19 year old basketball player complains of itching in the crural folds, buttocks, and upper thighs. The lesions are well demarcated and are half-moon shaped. The area is red, irritated, and there are small breaks in the skin from scratching. What is this patient’s diagnosis and how should it be treated?

Group of answer choices

Tinea cruris; treat with a topical antifungal cream
Eczema; treat with a topical steroid
Scabies; treat with permethrin cream
Syphilis; treat with penicillin

Question 2

Which of the following is a predisposing condition for furunculosis?

Group of answer choices

Diabetes mellitus
Hypertension
Peripheral vascular disease
Chronic fatigue syndrome

Question 3

A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:

Group of answer choices

“It is the most common cause of death in patients with skin cancer.”
“It can be cured with surgical excision or radiation therapy.”
“It is a slow growing skin cancer that rarely undergoes malignant changes.”
“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.”

Question 4

Marvin has sudden eye redness that occurred after a strenuous coughing episode. You diagnose a subconjunctival hemorrhage. Your next step is to

Group of answer choices

Refer him to an ophthalmologist
Order antibiotics
Do nothing other than provide reassurance
Consult with your collaborating physician

Question 5

Which of the following statements about malignant melanomas is true?

Group of answer choices

They usually occur in older adult male
The patient has no family history of melanoma
They are common in blacks
The prognosis is directly related to the thickness of the lesion

Question 6

Your 31-year-old patient, whose varicella rash just erupted yesterday, asks you when she can go back to work. What do you tell her?

Group of answer choices

Once all the vesicles are crusted over
When the rash is entirely gone
Once you have been on medication for at least 48 hours
Now, as long as you stay away from children and pregnant women

Question 7

If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:

Group of answer choices

Iritis
Allergic conjunctivitis
Viral conjunctivitis
Bacterial conjunctivitis

Question 8

Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

Group of answer choices

Cataracts
Glaucoma
Retinal detachment
Iritis

Question 9

A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?

Group of answer choices

Prescribe an antifungal powder for application between her toes and in her shoes and a topical prescription strength antifungal cream for other affected areas. Monitor for a secondary bacterial infection.
Prescribe an oral antifungal for 4 to 12 weeks. Monitor BUN and creatinine at 1 week, 2 weeks, and every month thereafter.
Prescribe an oral antifungal for 4 to 12 weeks. Monitor liver enzymes, BUN, and creatnine at 1 week, 2 weeks, and every month thereafter.
Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary bacterial infection.

Question 10

Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

Group of answer choices

Herpes simplex
Aphthous ulcers
Candidiasis
Oral cancer

Question 11

What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

Group of answer choices

You must initiate the plan of care for the patient
The physician must be on-site and engaged in patient care
You must be employed as an independent contractor
You must be the main health care provider who sees the patient

Question 12

Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices?

Group of answer choices

It is important to “undercode” so that one does not get charged with Medicare fraud
The practice of “overcoding” is essential in this age of decreasing reimbursements
Failing to bill for billable services will lead to unnecessarily low revenues
Time spent with the patient is a very important determinant of billing

Question 13

Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:

Group of answer choices

Quit smoking
Maintain aggressive hypertension therapy
Stick to a low-fat, low-sodium diet
Continue with his exercise program

Question 14

Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?

Group of answer choices

Varicella
Herpes zoster
Syphilis
Rubella

Question 15

Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?

Group of answer choices

Aspirin
NSAIDs
Opioids
Antihistamines

Question 16

Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate?

Group of answer choices

An antihistamine intranasal spray
A decongestant nasal spray
Ipratropium
Omalizumab

Question 17

Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?

Group of answer choices

Pharmacological therapy
A labyrinthectomy
A vestibular neurectomy
Wearing an earplug in the ear with the most hearing loss

Question 18

The Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following?

Group of answer choices

Fever history
Tender, swollen anterior cervical lymph nodes
Positive rapid antigen detection test
A and B only
A, B, and C

Question 19

Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:

Group of answer choices

Sex hormones
Trauma or inflammation
A dietary change
Scurvy

Question 20

A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?

Group of answer choices

Any recent trauma
Difficulty swallowing
Stiffness in the right shoulder
Change in sleeping habits

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