Patient Management Flashcards
6 cards from real Family Nurse Practitioner Test practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Patient Management flashcards as text
An elderly patient is found to have a serum sodium of 128 mEq/L with euvolemia. Which is the MOST appropriate initial management?
Answer: Fluid restriction and identify underlying cause (e.g., SIADH)
Euvolemic hyponatremia (SIADH) is managed with fluid restriction and identifying the underlying cause; rapid correction risks osmotic demyelination syndrome.
A 4-year-old is brought in by parents for fever and appears non-toxic. On exam the FNP notes a petechial rash that does NOT blanch with pressure. The PRIORITY action is:
Answer: Emergency transfer to the ED for suspected meningococcemia
Non-blanching petechiae with fever can indicate meningococcemia (Neisseria meningitidis), a rapidly fatal condition requiring immediate emergency evaluation and IV antibiotics.
A patient with bipolar I disorder is started on lithium. Which parameter requires the MOST vigilant monitoring?
Answer: Serum lithium level, renal function (creatinine), and thyroid function
Lithium has a narrow therapeutic index, is renally excreted, and causes hypothyroidism; regular serum levels, renal function, and thyroid function tests are mandatory.
The FNP is counseling a postmenopausal woman on hormone therapy (HT). Which combination is preferred for a woman WITH a uterus?
Answer: Estrogen plus progestogen (combined HT)
Women with an intact uterus must receive progestogen with estrogen to prevent unopposed estrogen stimulation causing endometrial hyperplasia and cancer.
A patient with chronic kidney disease and secondary hyperparathyroidism has low calcium and elevated phosphorus. The FNP should FIRST address:
Answer: Phosphorus restriction and phosphate binders
Hyperphosphatemia drives secondary hyperparathyroidism in CKD; dietary phosphorus restriction combined with phosphate binders is the first-line approach.
A patient newly diagnosed with rheumatoid arthritis has active synovitis. Per ACR guidelines, which is the FIRST-LINE disease-modifying agent (DMARD)?
Answer: Methotrexate
Methotrexate is the anchor DMARD for rheumatoid arthritis, recommended as first-line therapy due to its efficacy, long-term safety profile, and cost-effectiveness.