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 taken by 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 of the 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>

does not need to be adjusted."

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

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 on lap).

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 problem in 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 upper eyelid 

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, and the 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 of which 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?