2023/2024 AANP PRACTICE QUESTIONS WITH CORRECT ANSWERS GRADED A+, Exams of Nursing

Download 2023/2024 AANP PRACTICE QUESTIONS WITH CORRECT ANSWERS GRADED A+ and more Exams Nursing in PDF only on Docsity! 2023/2024 AANP PRACTICE QUESTIONS WITH CORRECT ANSWERS GRADED A+ A mother has just noticed that her 15-month-old, 15-kg child has recently ingested an unknown quantity of iron tablets. The mother has ipecac syrup and activated charcoal on hand. The mother should be advised to: 1. take the child to the primary care provider. 2. give ipecac per recommendation on the bottle label. 3. take the child to the emergency room. 4. give the child 30 g of activated charcoal diluted with water - correct answer✅take child to emergency room A 13-year-old is concerned because she has not yet begun to menstruate. Physical examination indicates that the patient is at Tanner stage IV and is of average height and weight. Which of the following would be the most appropriate response to this patient? 1. "We'll need to refer you to an endocrinologist for a complete workup." 2. "We'll need to do some tests to find out why you are not having periods." 3. "I'll give you some pills that will make your periods start." 4. "Your development is exactly as expected for your age; you'll probably begin to have periods within a year." - correct answer✅"Your development is exactly as expected for your age; you'll probably begin to have periods within a year." The most common bacterial cause of cellulitis in patients with diabetes mellitus is: 1. Pseudomonas aeruginosa. 2. group B beta-hemolytic Streptococcus. 3. Staphylococcus aureus. 4. Staphylococcus saprophyticus. - correct answer✅Staphylococcus aureus A 46-year-old female found a lump in her breast this morning. History includes: no prior breast disease; G2P2 (first birth, age 22); maternal aunt diagnosed with breast cancer at age 72; last menstrual period was 2.5 weeks ago. On examination, a nurse practitioner palpates a 2-cm round, soft, mobile, tender lesion in the upper outer quadrant of the right breast. Mammogram is negative. Which of the following actions is most appropriate? 1. Reassure the patient that no further action is necessary. 2. Repeat unilateral right mammogram in 3 months. 3. Schedule a right-breast ultrasound. 4. gastroesophageal reflux disease. - correct answer✅GERD A late adolescent patient presents with complaints of acute-onset unilateral right eye pain, visual changes, seeing halos around lights, abdominal pain, and intermittent nausea. Physical findings include an erythematous right eye without discharge, a cloudy cornea, and a moderately dilated right pupil that is nonreactive to light. The nurse practitioner should immediately: 1. apply steroid drops to the right eye. 2. apply mydriatic drops to the eye. 3. refer to the emergency department. 4. make an appointment for him to see an ophthalmologist. - correct answer✅refer to emergency department In a 6-year-old child, which of the following is the preferred drug for stage 1 Lyme disease? 1. Trimethoprim-sulfamethoxazole (Bactrim) 2. Azithromycin (Zithromax) 3. Doxycycline (Doryx) 4. Cefuroxime (Ceftin) - correct answer✅cefuroxime (ceftin) An 86-year-old patient is experiencing radiculopathy-associated lower back pain that has not improved over the past 4 weeks. The medical history includes a lumbar discectomy. The best type of imaging study for evaluating this patient would be a/an: 1. MRI. 2. spinal X-ray. 3. myelography. 4. nuclear bone scan. - correct answer✅MRI A 30-month-old with a history of frequent ear infections was seen in September after a symptom-free summer. Examination revealed bilateral bulging eardrums. After two separate courses of antibiotics, fluid is noted in both ears. The parent reports speech difficulties. The most likely diagnosis is: 1. otitis media with effusion. 2. myringitis. 3. recurrent acute otitis. 4. Esutachian tube dysfunction. - correct answer✅otiti media with effusion A 19-year-old patient who has used oral contraceptives for 3 years plans to discontinue the pill at the end of her current cycle to become pregnant. Which of the following daily supplements would receive the highest priority? 1. Calcium carbonate 2. Folic acid 3. Ferrous sulfate 4. Multivitamin - correct answer✅folic acid A frail elderly widow presents to the senior clinic with a 3- to 4-day history of confusion that became worse the evening before but currently seems a little better, although her speech is rambling and difficult to follow. During the examination, the patient is anxious and agitated. She is on cardiac medications, an antidepressant, and insulin. The most likely diagnosis is: 1. mild stroke. 2. polypharmacy. 3. electrolyte imbalance. 4. agitated depression. - correct answer✅polypharmacy 2. refer to physical therapy. 3. start methocarbamol (Robaxin). 4. discontinue amitriptyline and begin gabapentin (Neurontin). - correct answer✅discontinue amitriptyline and begin gabapentin (neurontin) A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and omeprazole (Prilosec). The patient complains of headache, abdominal pain, and gas. These symptoms are most likely: 1. associated with the omeprazole. 2. related to the underlying condition. 3. the result of the NSAID. 4. caused by viral gastroenteritis. - correct answer✅associated with the omeprazole The medication of choice for the initial treatment of juvenile rheumatoid arthritis is: 1. acetaminophen. 2. prednisone. 3. aspirin. 4. ibuprofen. - correct answer✅ibuprofen A 12-year-old with sickle cell anemia has recently experienced a sickle cell crisis and presents for a follow-up examination after a recent hospitalization. It is most important to continue monitoring growth, development, and: 1. white blood cell levels. 2. fecal occult blood test. 3. hemoglobin levels. 4. urine dipsticks. - correct answer✅hemoglobin levels A 90-year-old female is brought to the clinic by her neighbor. She states that everything is fine, but the nurse practitioner notes that she has poor hygiene and bruises on her trunk. The neighbor is concerned that the patient often has no money to buy food, despite income from social security and a coal miner's pension. The nurse practitioner suspects abuse. Which of the following is the nurse practitioner obligated to do next? 1. Report the case to the proper authorities. 2. Tell the neighbor to check on the woman daily and report back. 3. Document the data and report the information to risk management. 4. Call the patient's family and inquire about the concerns. - correct answer✅report the case to proper authorities In most cases, the first manifestation of Alzheimer's disease is: 1. impaired judgment. 2. decrease in short-term memory. 3. disorientation in time and place. 4. decrease in long-term memory. - correct answer✅decrease in short-term memory The optimal treatment for latent tuberculosis is: 1. rifampin (Rifadin) for 5 months. 2. isoniazid (Nydrazid) for 9 months. 3. pyrazinamide for 6 months. 4. ethambutol for 6 months. - correct answer✅osioniazid (nydrazid) for 9 months Unilateral spontaneous serous or serosanguineous discharge from a single duct of a breast is most often caused by: 2. MRI 3. CT scan 4. Pet scan - correct answer✅CT scan The most important diagnostic factor in evaluating angina pectoris is the patient's: 1. King of Heart's monitor. 2. physical examination. 3. history. 4. echocardiogram. - correct answer✅history There are three reasons for latex allergies. Which of the following does NOT cause the problem? 1. Immediate hypersensitivity 2. Irritant contact of dermatitis 3. Cytotoxic hypersensitivity 4. Immune complex reaction - correct answer✅cytotoxic hypersensitivity A patient on warfarin (Coumadin) therapy for recurrent deep vein thrombosis (DVT) is about to have lumbar spinal fusion surgery. The patient's warfarin is put on hold starting 5 days prior to the surgery and subcutaneous Lovenox has been ordered for DVT prophylaxis until the resumption of the warfarin. The nurse practitioner knows that the patient's postoperative warfarin dose should be restarted based on the: 1. value of her morning Prothrombin time. 2. loading dose of 10 mg, plus the previous warfarin dose. 3. baseline PT and INR values. 4. target INR of 2. - correct answer✅caseline PT and INR values An 87-year-old patient presents with round, pruritic plaques and small vesicles on the lower legs. The most likely diagnosis is: 1. allergic contact dermatitis. 2. plaque psoriasis. 3. cutaneous T-cell lymphoma. 4. nummular eczema - correct answer✅nummular eczema A 3-year-old presents with a 2-day history of acute diarrhea with a total of 8 watery stools without blood or mucus, and 2 episodes of vomiting in the past 48 hours. Assessment reveals no current antibiotic therapy, dehydration <5%, soft abdomen with hyperactive bowel sounds, no masses or organomegaly; other physical findings are normal. Which of the following is the most appropriate management plan? 1. Stool culture; Immodium AD liquid. 2. No laboratory workup; instruct parents on signs and symptoms of dehydration; diet of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup. 3. Start diet of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup over next 72 hours; Imodium AD liquid, 1 mg/sml 4. Stool for ova and parasites; advise parents of likely sources of Giardia; prescribe furazolidone (Furoxone) - correct answer✅No laboratory workup; instruct parents on signs and symptoms of dehydration; diet of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup. A mother presents her 12-month-old child with concern because the child does not yet say "mama" or "dada." The mother reports that in the first months of life, the child loved listening to music and being talked to. The past medical history is negative for ear infections. The nurse practitioner should: 4. Decreased secretions - correct answer✅increased peristalsis Type 2 diabetes mellitus is characterized by which of the following? 1. Decreased production of exogenous glucagon-like peptide 2. Autoimmune beta-cell destruction 3. Relative deficiency of dipeptidyl peptidase-4 4. Decreased reabsorption of sodium-glucose transporters - correct answer✅decreased reabsorption of sodium-glucose transporters In pulmonary function testing, forced vital capacity represents the: 1. maximum volume of air that can be forcefully exhaled after maximum inspiration. 2. total volume of air that is exhaled after normal inspiration. 3. total volume of air that the lungs can hold, minus the expiratory reserve volume. 4. volume of air that can be forcefully exhaled in 1 second. - correct answer✅maximum volume of air that can be forcefully exhaled after maximum inspiration An adult male presents as first patient of the day after awaking about 5:00 AM with indigestion and chest pressure. On checking his pulse, he found no change from previous measurements. He states that, while waiting for the nurse practitioner to arrive, he began to feel a little clammy. A 12-lead EKG records the following patterns. On the basis of these EKG readings, the diagnosis is: 1. anterior-septal acute myocardial infarction. 2. lateral acute myocardial infarction. 3. inferior acute myocardial infarction. 4. anterior acute myocardial infarction. - correct answer✅inferior acute myocardial infarction During the past 24 hours, a 62-year-old has experienced abdominal pain that radiates to the back. The patient also reports several episodes of nausea and vomiting, a low-grade temperature, and a history of excessive drinking. Physical examination reveals a distended abdomen. Laboratory serum values indicate elevated alkaline phosphatase, amylase, and serum lipase. The most likely diagnosis is: 1. alcoholic liver disease. 2. acute mesenteric ischemia. 3. viral hepatitis. 4. acute pancreatitis. - correct answer✅acute pancreatitis An otherwise healthy adult female presents complaining of vaginal burning and itching during urination. She has a social history of two sexual partners. She denies fever or vaginal discharge, but has noted a lesion on one labium. The nurse practitioner should order all of the following EXCEPT: 1. wet mount and potassium hydroxide. 2. dark-field microscopy of fluid from the lesion. 3. nucleic acid amplification testing for gonorrhea. 4. serology for Haemophilus ducreyi. - correct answer✅dark-field microscopy of fluid from lesion A 3-year-old female has been diagnosed with bacterial meningitis. She attends preschool daily at a local church day care program. The day before her diagnosis, she ate lunch with her mother at a local restaurant. For which contact(s) would chemoprophylaxis with rifampin be recommended? 1. Preschool contacts in the past 7 days 2. A friend of the patient's sister who visited after school yesterday 1. Painters 2. Only children 3. High-level athletes 4. Individuals from large families - correct answer✅high level athletes A frail elderly patient presents with constipation. Which of the following normal physiologic changes seen with aging is the most likely cause? 1. Decreased bowel muscle tone 2. Increased bile secretion 3. Increased absorption of calcium 4. Decreased pancreatic secretions - correct answer✅decreased bowel muscle tone A patient reports to your office, having been struck on the right cheek with a baseball bat. On examination, you notice tenderness and swelling over the cheek. The patient is unable to gaze laterally with his left eye, and he complains of double vision when he attempts to do so. This is most likely associated with: 1. retinal hemorrhage. 2. orbital rim fracture. 3. subarachnoid hemorrhage. 4. periorbital cellulitis. - correct answer✅orbital rim fractures A 7-year-old child presents with group A streptococcal infection confirmed by throat culture. Past history includes treatment for positive streptococcal infection with erythromycin (EryPed oral suspension) 3 weeks ago. What is the most appropriate next intervention? 1. Treat with amoxicillin for 10 days. 2. Obtain culture for all household members. 3. Treat with azithromycin (Zithromax) for 10 days. 4. Intramuscular Penicillin. - correct answer✅treat with amoxicillin for 10 days A 16-year-old female adolescent is brought to the nurse practitioner's office by her mother, who is concerned about her daughter's recent weight loss. History reveals that the daughter was consistently in the 50th percentile for weight, but is now in the 10th percentile. The mother states that she is concerned that her daughter is purging herself after meals since she often goes to the restroom after eating and remains there for a long period of time. The daughter denies any self- induced vomiting, starvation or excessive activity. She does state that she jogs five miles a day and is in good condition. In addition to a complete blood count with differential, which of the following laboratory tests will be most helpful for further assessment? 1. Electrolytes, fasting blood sugar 2. Creatine phosphokinase, follicle-stimulating hormone (FSH) 3. Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis 4. Electrolyt - correct answer✅electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis An adult female who is homeless presents for an initial obstetric visit at 34 weeks of pregnancy. She is diagnosed with Chlamydia trachomatis infection. What complication will her newborn be most at risk? 1. Conjunctivitis 2. Hearing loss 3. Pneumonitis 4. Meningitis - correct answer✅conjunctivitis A 2-year-old male presents for reevaluation. Two days ago, he had four episodes of vomiting and six diarrheal stools. On physical examination today, his vital signs reveal P = 120 and capillary refill of 3 seconds. The patient's eyes are sunken and 1. muscle cramps 2. mild irritability. 3. increased heart rate. 4. slight increase in growth velocity. - correct answer✅slight increase in growth velocity A geriatric female presents for her annual examination. She has been on antihypertensive medications for over 20 years, with good control. Laboratory values are within normal ranges. The nurse practitioner is concerned about the patient's cardiac health risks, due her to weight and her waist circumference. According to the AHA guidelines, which of the following goals is expected for this patient? 1. Physical activity for 60 minutes daily, for a minimum of 6 days a week 2. Physical activity for 30 minutes daily, 7 days a week 3. Physical activity for 30 minutes daily, for a minimum of 5 days a week 4. Physical activity for 60 minutes daily, 7 days a week - correct answer✅physical activity for 30 minutes daily, for a minimum of 5 days a week The management of COPD in the elderly is best guided by: 1. spirometry. 2. arterial blood gases. 3. radiologic imaging. 4. symptomatology. - correct answer✅symptomatology A young, athletic adult presents with shoulder pain and inability to raise the arm above the shoulder. The most likely diagnosis is: 1. frozen shoulder syndrome. 2. cervical radiculopathy. 3. rotator cuff tear. 4. polymyositis. - correct answer✅rotator cuff tear A 50-year-old male presents with bruises and abrasions on the left leg and forearm, claiming to have had a number of minor accidents at home and at work. The patient reports general feelings of depression, forgetfulness, and, despite the fact that he is regularly employed, a mounting collection of unpaid and overdue bills. In taking the patient's history, a significant pattern of parental alcohol abuse, stroke, TIA, and MI emerges. During questioning to elicit a more thorough diagnosis, the patient becomes hostile and leaves the clinic without further treatment. The most likely explanation for this behavior is: 1. Alzheimer's disease. 2. chronic alcoholism. 3. cancer. 4. carotid artery stenosis. - correct answer✅chronic alcoholism A 28-year-old patient presents with profuse yellow vaginal discharge, odor, and local irritation. She reports completing a 7-day course of oral metronidazole (Flagyl), 500 mg b.i.d. 4 weeks ago. She has had multiple recurrences over the last 18 months. Microscopic examination reveals presence of clue cells. What is the most appropriate treatment intervention? 1. Oral metronidazole (Flagyl), 500 mg b.i.d., plus metronidazole vaginal gel (MetroGel), for 5 days 2. Treat both patient and partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d., for 7 days 3. Metronidazole vaginal gel (MetroGel) twice weekly for 4 to 6 months A 70-year-old patient presents to the clinic complaining of dyspnea, palpitations, and fatigue. The patient reports a 2-week history of blackened stools, which the patient attributes to drinking berry juice. Assessment reveals vital signs of BP = 110/60, P = 100, R = 24; Hgb = 4.5 g/dL; Hct = 16%. What is the most appropriate immediate intervention? 1. Order serum iron, total iron-binding capacity (TIBC), and ferritin. 2. Refer to a gastroenterologist. 3. Send to the emergency room. 4. Order a complete blood count (CBC) with differential. - correct answer✅Send to emergency room The symptoms of benign prostatic hypertrophy are often overlooked because the older male: 1. understands that surgery is the only cure for this condition. 2. considers urinary problems to be a normal part of aging. 3. is fearful of the side effects of additional medication. 4. is concerned that he will no longer be able to obtain an erection. - correct answer✅considers urinary problems to be normal part of aging Upon admission to a nursing home, an 85-year-old patient receives a negative result on the purified protein derivative (PPD) test. To determine TB status in the frail elderly, a second PPD should be performed in: 1. 72 hours. 2. 1 week. 3. 3 months. 4. 6 months. - correct answer✅1 week Which of the following is NOT used for therapy of an acute attack of gout? 1. Colchicine (Colcrys) 2. Indomethacin (Indocin) 3. Methylprednisolone (Solumedrol) 4. Allopurinol (Zyloprim) - correct answer✅allopurinol (zyloprim) A 26-year-old female presents with abdominal distention, bloating, and intermittent crampy abdominal pain relieved by defecation. She has four to six loose stools a day when stressed. Between bouts of diarrhea, she often has constipation. Physical examination results are normal. The CBC was normal. The most likely diagnosis is: 1. diverticulitis. 2. viral gastroenteritis. 3. inflammatory bowel disease. 4. irritable bowel syndrome - correct answer✅irritable bowel syndrome