A 35-year-old female with a history of migraines presents to the clinic with worsening

symptoms for the past few weeks. She reports waking up at night with headaches and

nausea. Her only medication history is oral contraceptive pills (OCPs). Otherwise, she 

states she is healthy. Which of the following actions if takenby the NP is the best next

step?

Take a further history and perform a very careful neurological exam

A grandmother is accompanying her 9-year-old granddaughter during a routine

physical examination. She asks you privately if her granddaughter has started puberty

yet. During the examination, the NP notes asymmetric projection of the areola and nipple

of the right chest to form a secondary mound above the level ofthe breast. The left breast

is underdeveloped. These assessment findings are consistent with which Tanner Stage of

development?

IV

Primary prevention is defined as which of the following?

Interventions designed to prevent disease

Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of 

the following statements is true about screening for breast cancer in average-risk women?

Mammography is recommended every 2 years for women aged 50-74 with

insufficient evidence for screening women over the age of 75.

Which of the following statements is true regarding recommendations by the eighth Joint

National Committee (JNC8) for adults aged 60 and older? Select all that apply.

Target blood pressure should be </= 150/90 mmHg but notes that if treatment results

in SBP <140>

treatment does not need to be adjusted.”

In those aged 80 or older, blood pressure targets of 140 to <150>

optimal for notable reductions in stroke, cardiovascular events, and all-cause mortality.

Which of the following is a useful strategy when examining young children between the

ages of 1 and 4?

Have the parent facilitate the exam (e.g., removing clothes, holding the child onlap).

The NP is completing the review of systems on a 4-month-old female during a routine 

encounter. Which statement from the parent may indicate a cardiac problemin the infant

and require a more thorough subjective history?

“It often takes the baby more than 30 minutes to finish a bottle.”

A 16-year-old male presents to the clinic with a history of a congenital right uppereyelid

drooping as represented in this image. He has no complaints and denies injury or 

trauma. Which cranial nerve (CN) is involved in this condition?

Patient with eyelid drooping

CNIII

Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory

fibers to portions of the tympanic membrane, auditory canal, pharynx, andthe posterior

third of the tongue?

CN IX

The NP should suspect injury to which cranial nerve (CN) if a patient presents with

complaints of photosensitivity and uneven pupils after being struck in the eye with a

baseball?

CNIII

Which of the following statements is true regarding risks and rapid recognition of

suspected stroke? Select all that apply

Obesity doubles the risk of stroke even without associated glucose intolerance

Hypertension is the leading risk factor for both ischemic and hemorrhagic stroke

The combination of both receptive and expressive aphasia is a characteristic ofwhich

type of speech disorder?

global aphasia

The NP is assessing a 42-year-old female who presents to the clinic with recurring

headaches. What is an effective question to ask the patient?

Do you have any aura prior to the headaches?

A 55-year-old female presents to the clinic with a headache. During the interview,which

of the following symptoms should prompt the NP to be concerned and investigate

further?

The patient reports fever, night sweats, and thinks she lost weight.