Fnp, Ancc Test Questions

Front 1

The Patient Bill of Rights legislation has impacted primary healthcare delivery. All of the following are true regarding this EXCEPT:
It requires nurse practitioners to sign a contract with the federal government.
It includes provisions for a process for consumers to appeal the decisions of managed care organizations (MCO).
It requires managed care organizations to pay for certain emergency services.
It prescribes the availability of care.

Back 1

It requires nurse practitioners to sign a contract with the federal government

Nurse practitioners do not have to sign a contract with the federal government under the Patient Bill of Rights legislation. It has increased the understanding of managed care and the problems and ethical dilemmas that are associated with this healthcare approach.

Front 2

You have prescribed Cymbalta for a patient with depression. The patient should be educated about all but which of the following potential side effects of this drug?
Weight loss.
Dry mouth.
Nausea.
Hair loss.

Back 2

Hair loss Cymbalta has not been linked with hair loss. Weight loss is a potential side effect of this drug. Dry mouth and nausea have also been reported. These side effects are generally mild and not cause for concern, though patients should be made aware of them.

Front 3

A 25-year-old obese Caucasian female presents with a complaint of excessive hair growth on her face, upper lip region, and pubic area. The history and exam reveals hirsutism, normal plasma androgens and regular normal menses. The diagnosis is most likely:
polycystic ovarian disease
Cushing's syndrome
idiopathic
an ovarian tumor

Back 3

Idiopathic

The hirsutism would be considered idiopathic because of normal menstrual periods and androgen levels. Disease related to the ovaries would cause changes in menses. With Cushing's syndrome, you would see adrenal androgen overproduction.

Front 4

Gross painless hematuria is the most common presenting sign of bladder cancer. Persistent microscopic hematuria is the only finding in about what percentage of individuals presenting with bladder cancer?
20%
25%
35%
50%

Back 4

20%

Persistent microscopic hematuria is the only finding in about 20% of individuals presenting with bladder cancer. Irritative voiding symptoms and urinary frequency without fever are reported occasionally. Abdominal mass is palpable only with advanced disease.

Front 5

Sigmund Freud identified stages of psychosexual development. Which of the stages of childhood is the phallic stage?
preschool
adolescence
toddler
school age

Back 5

The phallic stage is during the preschool years (3 – 6 years of age). During the phallic stage, the primary focus of the libido is on the genitals. At this age, children also begin to discover the differences between males and females.

Front 6

An elderly patient presents with insomnia. She states that a family member was prescribed a medication for his insomnia and asks if she can get the same. The NP responds that this drug is rarely used in the elderly population, very dangerous, and has been known to cause hyperkinesia and ataxia. Which drug are the patient and NP MOST likely talking about?

Back 6

Barbiturates Barbiturates, Benzodiazepines, Zolpidem and Zaleplon are all drugs that have been approved to treat insomnia. However, Barbiturates are not typically used in elderly patients and has many adverse effects such as hallucination and nervousness.

Front 7

Medicaid is a health insurance plan that many nurse practitioners (NPs) will submit claims to for reimbursement of services rendered to patients. It is important that the NP has understanding of this program. All of the following are true statements regarding Medicaid EXCEPT:
Medicaid funds are provided by the federal government and administered by the states.
The Omnibus Budget Reconciliation Act of 1989 allowed for NPs to receive direct payment in the Medicaid program without the need for supervision or association with physicians or other health care providers.
All states have complied with federal legislation mandating Medicaid coverage of pediatric services in Medicaid programs.
Very few states at this time include nurse practitioners in coverage for their Medicaid programs.

Back 7

ery few states at this time include nurse practitioners in coverage for their Medicaid programs

The majority of states include all nurse practitioners in coverage for their Medicaid programs. Therefore, the answer choice, "very few states at this time include nurse practitioners in coverage for their Medicaid programs," is incorrect.

Front 8

Which of the following immunizations would be the least likely to be administered to a child between the ages of 1 and 5 years old?
DTaP
MMR
Hib
Meningococcal

Back 8

Meningococcal

Meningococcal vaccine would not normally be administered to children of this age. However, it may be administered to children aged 2 to 10 years with terminal complement deficiencies or anatomic or functional asplenia and certain other high-risk groups.

Front 9

The following are recommended immunizations for healthy young adults:
influenza, measles, rubella, hepatitis B, and tetanus
tetanus, influenza, varicella, pneumovax, and hepatitis B
pneumovax, rubella, and influenza
measles, mumps, and rubella, varicella, and hepatitis B

Back 9

Influenza, measles, rubella, hepatitis B, and tetanus

Five to twenty percent of young adults are susceptible to measles and/or rubella. Hepatitis B and influenza vaccines are recommended for the student population. In addition, a tetanus vaccine is recommended every 10 years, especially in young adults who participate in outdoor sports.

Front 10

Fraud and abuse by healthcare providers have increased during the last several years. Which of the following is correct concerning fraud and abuse?
The federal Health Insurance Portability and Accountability Act (HIPAA) allow for broad penalties for defrauding a health plan.
The Health Insurance Portability and Accountability Act (HIPAA) prohibits knowingly and willfully offering, paying, soliciting, or receiving anything of value in order to induce furnishing of services under federal and state programs.
The federal False Claims Act maintains a list of "safe harbors," which are arrangements that will not be considered a violation of the anti-kickback law.
There are no laws that limit physicians from directing patients to their privately owned laboratories or diagnostic centers.

Back 10

The federal Health Insurance Portability and Accountability Act (HIPAA) allow for broad penalties for defrauding a health plan

The Health Insurance Portability and Accountability Act (HIPAA) provides required guidelines a health plan, provider and healthcare organization must adhere to in regards to fraud and abuse. Also, HIPAA has privacy rules that outlines protective measures that healthcare organizations must follow in order to keep patient health information private. Or, in the case of health insurance plans, HIPAA has mandates the health plans must follow in order to keep member health information private. Further, the federal anti-kickback statute prohibits knowingly and willfully offering, paying, soliciting, or receiving anything of value in order to induce furnishing of services under federal and state programs. The federal False Claims Act imposes civil liability on anyone who submits a false claim. The Stark I and II federal laws prohibit physicians from self-referring patients and then receiving payment for the referral.

Front 11

How often would you screen a 60 year old patient without any major risk factors for melanoma?
Every five years.
Every three years.
Every four years.
Every year.

Back 11

Every five years Melanoma is typically screened every five years. This may need to be more frequent if the patient has risk factors for skin cancer.

Front 12

Certain foods are known to be potential dietary triggers influencing the onset or severity of migraine symptoms. When counseling a patient on these, which is NOT considered a trigger?
onions
ripened cheeses
vanilla ice cream
caffeinated beverages

Back 12

Vanilla ice cream is not on the list as triggers for a migraine headache. However, "chocolate" is. Also included as trigger foods are onions, caffeinated beverages, ripened cheeses, sour cream, sausage, bologna, salami, pepperoni, hot dogs, pizza, chicken liver, herring, pickled foods, monosodium glutamate, yeast products, nuts or nut butters, various beans, figs, raisins, papayas, avocados, red plums, citrus foods, bananas, alcoholic beverages and aspartame.

Front 13

During a pelvic exam with a 27 year old female patient, you feel a mass on one of the ovaries. The patient has a history of painful periods and a family history of endometriosis. Which of the following is NOT a procedure you might order to confirm whether the patient has an endometrial filled cyst on her ovary?
CT scan.
MRI.
Transvaginal ultrasound.
Hysterosonogram.

Back 13

Hysterosonogram In this procedure, the uterus is filled with saline and then examined via ultrasound. It is effective for diagnosing uterine fibroids. Since you are concerned with the ovaries of this patient, this is not an effective diagnostic procedure. Any of the other choices are viable nonsurgical options for diagnosing this patient.

Front 14

The system designed to evaluate and monitor the effectiveness and efficiency of patient care is which of the following?
performance assessment
risk management
code of ethics
quality assurance

Back 14

quality assurance

Quality assurance is the system designed to evaluate and monitor the effectiveness and efficiency of patient care. Quality assurance programs promote responsibility and accountability to deliver high-quality care, assist in the evaluation and improvement of patient care, and provide for an organized means of problem solving.