NP Risk Assessment & Management 2 — Questions and Answers
Question 1: A 72-year-old patient scores 18 on the Morse Fall Scale. Which intervention is MOST appropriate?
- Apply a fall-risk armband and notify all staff
- Initiate bed alarms, non-slip footwear, and hourly rounding (Correct answer)
- Restrict the patient to bed rest
- Place the patient in a room closest to the nursing station only
Correct answer: Initiate bed alarms, non-slip footwear, and hourly rounding
A Morse Fall Scale score ≥25 indicates high risk; multi-component interventions including bed alarms, non-slip footwear, and hourly rounding are evidence-based fall prevention strategies.
Question 2: When using the Wells criteria to assess DVT risk, which finding adds the MOST points to the pretest probability score?
- Heart rate >100 bpm
- Active cancer treatment
- Paralysis or recent cast immobilization of a lower extremity (Correct answer)
- Alternative diagnosis at least as likely as DVT
Correct answer: Paralysis or recent cast immobilization of a lower extremity
Paralysis, paresis, or recent plaster immobilization of the lower extremities adds 1 point, but the 'alternative diagnosis at least as likely' deducts 2 points, making immobilization a key positive contributor.
Question 3: A nurse practitioner screens a 55-year-old male smoker for abdominal aortic aneurysm (AAA). Per USPSTF guidelines, what is the recommended screening test and frequency?
- CT angiography once at age 55
- One-time abdominal ultrasound between ages 65–75 (Correct answer)
- Annual abdominal ultrasound starting at age 50
- Duplex ultrasonography every 5 years starting at age 50
Correct answer: One-time abdominal ultrasound between ages 65–75
The USPSTF recommends one-time abdominal ultrasound screening for AAA in men aged 65–75 who have ever smoked (≥100 cigarettes lifetime).
Question 4: Which tool is BEST validated for assessing suicide risk in the primary care outpatient setting?
- Columbia Suicide Severity Rating Scale (C-SSRS) (Correct answer)
- Beck Depression Inventory (BDI-II)
- Patient Health Questionnaire-9 (PHQ-9) item 9 alone
- Hamilton Rating Scale for Depression
Correct answer: Columbia Suicide Severity Rating Scale (C-SSRS)
The C-SSRS is the gold-standard, widely validated tool specifically designed to stratify suicide ideation and behavior severity across clinical settings.
Question 5: A diabetic patient's 10-year ASCVD risk is calculated at 12%. According to ACC/AHA guidelines, which statin therapy intensity is recommended?
- No statin indicated; lifestyle modification only
- Low-intensity statin therapy
- Moderate-intensity statin therapy (Correct answer)
- High-intensity statin therapy
Correct answer: Moderate-intensity statin therapy
Patients with diabetes aged 40–75 with 10-year ASCVD risk ≥10% should receive high-intensity statin therapy per ACC/AHA 2019 guidelines.
Question 6: Which AUDIT-C score threshold in a male patient indicates a positive screen for unhealthy alcohol use requiring further assessment?
- ≥2
- ≥3
- ≥4 (Correct answer)
- ≥5
Correct answer: ≥4
An AUDIT-C score of ≥4 for men (≥3 for women) is the recommended threshold for a positive screen for unhealthy alcohol use.
Question 7: A 68-year-old female with osteoporosis is being started on bisphosphonate therapy. What baseline assessment is MOST critical before initiating treatment?
- Serum alkaline phosphatase level
- Dental examination to assess jaw health (Correct answer)
- 24-hour urine calcium excretion
- Bone marrow biopsy
Correct answer: Dental examination to assess jaw health
Osteonecrosis of the jaw (ONJ) is a known risk of bisphosphonate therapy; a dental examination to identify and treat existing dental disease is recommended before initiating treatment.
NP Risk Assessment & Management 2
A 72-year-old patient scores 18 on the Morse Fall Scale.
Which intervention is MOST appropriate?