AANP AGPCNP BEST PRACTICEQUESTIONS AND ANSWERS UPDATED 2023-2024 RATED A+, Exams of Nursing

Download AANP AGPCNP BEST PRACTICEQUESTIONS AND ANSWERS UPDATED 2023-2024 RATED A+ and more Exams Nursing in PDF only on Docsity! AANP AGPCNP BEST PRACTICEQUESTIONS AND ANSWERS UPDATED 2023-2024 RATED A+ Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion? 1) Timolol 2) Gentamicin ophthalmic 3) Cromolyn optha 4) Olopatadine - correct answer ✅2) Gentamicin ophthalmic (Genoptic) A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated by movement. The patient reports that he participated in extensive house painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness or ecchymosis is present. What is the next step to be taken in order to make a diagnosis? 1) Xray of shoulder 2) Palpate structures around the shoulder. 3) MRI of shoulder 4) EMG - correct answer ✅2) palpate structures A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting. She has not missed any doses and uses no other medication. Which of the following is appropriate? 1) Changing to Ortho-Novum 1/35 2) Discontinue use 3) Providing reassurance 4) Double dose-for two days - correct answer ✅3) provide reassurance According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a current recommendation guideline for preventive care in elderly female patients? 1) Mammogram and clinical breast exams 2) Fecal Occult blood test and/or sig 3) Rubella serology or vaccination history 4) Pnuemo and influenza vaccines - correct answer ✅3) Rubella serology or vaccination history 1) elevated TSH 2) Thyroid enlargement 3) atrial fibrillation 4) abnormal T3 suppression - correct answer ✅3) atrial fibrillation A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the previous day. The eye was rinsed with over-the-counter eyewash, without relief. The patient denies visual disturbances or drainage. In formulating a plan of care, the nurse practitioner would FIRST: 1) send to ophthalmologists 2) florescreen staining 3) test visual field 4) prescribe eyedrops - correct answer ✅3) test visual field A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, the nurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris. The band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an: 1. corneal abrasion 2. arcus senilis 3. corneal ulcer 4. herpetic infection of the eye - correct answer ✅2) arcus senilis A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and a cough that has been present for 4 weeks. The diagnostic study to perform first would be: 1) xray 2) pulmonary function test 3) bronchoscopy 4) H & H - correct answer ✅1) xray (tb-night sweats) A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On physical examination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI systolic murmur at the apex. Further evaluation would include which of the following? 1) EKG, flat plate of the abdomen, lipid profile 2) Echocardiogram, Doppler, EKG 3) Labs and benzo's 4) EEG, Anxiety Scale, and electrolytes - correct answer ✅2) Echocardiogram, Doppler, EKG A healthy 84 y/o would like to start an exercise program, what would you do before this takes place? 1) physical exam 2) EKG 3) knee xrays 4) PT Stress test - correct answer ✅1) Physical Exam 29 y/o has uncomplicated Chlamydia infection will exhibit: 1) green penile discharge 2) uticartia 3) unremarkable symtpoms 4) penile ulcer - correct answer ✅3) unremarkable symptoms In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves: 1) decreased cardiac output. 2) loss of vascular tissue elasticity. 3) hyperactive baroreceptors - correct answer ✅2) loss of vascular tissue elasticity A 58-year-old female presents with shoulder and pelvic girdle pain for the past 6 months. She reports recent unintentional weight loss. On physical examination, there is pain on ROM, with no weakness noted. Laboratory studies show a low hemoglobin and an elevated sedimentation rate. Which of the following is the most likely diagnosis? 1) Polymyalgia rheumatica 2) polymyositis 3) osteoarthritis 4) Fibromyalgia - correct answer ✅1) polymyalgia rheumatica An 85-year-old male relates that on the way to his annual physical examination, he suffered a sudden loss of vision in his right eye characterized by "a bunch of lights" and a feeling that "a curtain came down." All of the following would be included in the differential diagnosis EXCEPT: 1) opthalmolic migraine 2) retinal detachment. 3) diabetic retinopathy. 4) TIA - correct answer ✅3) diabetic retinopathy A patient with diabetes mellitus who is on NPH and regular insulin split-dosing presents with complaints of early morning rise in fingerstick blood glucose. A review of self blood glucose monitoring reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens. This is most likely an example of: 1) insulin resistance 2) the Somogyi effect. 3) needing more insulin in the mornings 4) Need to increase insulin at night - correct answer ✅2) Somogyi effect In a healthy elder, which of the following TRADITIONALLY defines a positive urine culture? 1) ≥100,000 colonies/mL of a single organism 2) ≥10,000 colonies/mL of a single organism 3) ≥100,000 colonies/mL of a two or more organisms - correct answer ✅≥100,000 colonies/mL of a single organism A 55-year-old patient exhibits a verified serum calcium level of 13 mg/dL [normal = 8.9-10.2 mg/dL]. The next step in determining the presence of pathology is to order a: 1) BUN and serum creatinine. 2) 24 hour urine 3) parathyroid hormone level. 4) thyroid panel - correct answer ✅3) parathyroid hormone level An 88-year-old female presents with a 3-day history of vertigo. The patient has a past medical history of hypertension controlled with metoprolol, 50 mg daily. She reports that the presenting symptoms are constant, severe, and accompanied by nausea and vomiting. She denies experiencing diplopia, slurring of speech, chest 3) Squamous epithelial cells with stippling appearance and indistinct borders, many lactobacillus rods, few white blood cells - correct answer ✅2) Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells Which of the following physical findings would best alert a nurse practitioner to the probability of a herniated lumbar disc? 1) Positive Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 90° 2) Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30° 3) Negative Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 80° - correct answer ✅2) Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30° An 87-year-old obese female presents with complaints of calf pain in her right leg. The patient reports that the pain is increased with ambulation and has been increasing over the past 24 to 48 hours. The patient denies the following: any recent injury to the leg, smoking, or recent surgery. To assess this patient's symptoms, you would initially assess: 1) calf circumference and perform Doppler studies. 2) popliteal pulses and Doppler studies 3) Femoral pulses and skin temperature 4) Patrick's signs and popliteal pulses - correct answer ✅1) calf circumference and perform Doppler studies What type of exercise would you recommend for a 74-year-old patient with hypertension and degenerative joint disease (DJD)? 1) Stationary bike 2) Aqua exercises 3) aerobic walking - correct answer ✅2) Aqua exercises Trigeminal neuralgia 1) electric shock like unilateral pain 2) jaw pain extending to the neck 3) Bilateral burning pain - correct answer ✅1) electric shock like unilateral pain A manifestation of autonomic neuropathy in a 70-year-old patient with diabetes mellitus is: 1) tremors. 2) orthostatic hypotension. 3) hypertension 4) color blindness - correct answer ✅2) orthostatic hypotension The most common fluid and electrolyte imbalance in patients over 65 years of age is: 1) hypokalemia 2) due to dehydration. 3) Hypercalcemia 4) due to fluid overload - correct answer ✅2) due to dehydration 2) Osteoarthritis 3) Gouty arthritis - correct answer ✅1) Rheumatoid arthritis An 18-year-old college student presents for an athletic physical. When asked about current medications, she mentions she takes "some herb" she bought at the health food store for migraines and menstrual cramps. Which of the following herbal remedies has been commonly used for these conditions? 1) Echinacea 2) St. JOhn's Wort 3) ginko biloba 4) Feverfew - correct answer ✅4) Feverfew The most common bacterial agents responsible for pneumonia in older adults residing in the community are: 1) Streptococcus pneumoniae and Haemophilus influenzae. 2) staphylococcus aureas and Haemophilus influenzae. 3) Psuedomonas aeruginosa and Klebsiella pneumonae 4) Legionnaires and streptococcus pneumoniae - correct answer ✅1) Streptococcus pneumoniae and Haemophilus influenzae. Which cranial nerves test the oculomotor eye movement and strabismus? 1) CN I III, IV 2) CV III, IV and VI 3) CN III, V, VII - correct answer ✅2) CV III, IV and VI The management of COPD in the elderly is best guided by: 1) pulse oximetry 2) arterial blood gases 3) radiographic images 4) symptomology - correct answer ✅4) symptomology Which of the following is the most serious outcome of Barrett's esophagus? 1) Esophageal adenocarcinoma 2) esophageal varices 3) GERD 4) Stricture - correct answer ✅1) Esophageal adenocarcinoma Which of the following is most important in enhancing a nurse practitioner's clinical assessment when promoting health behaviors in young adults? 1) Personality 2) Include the parents with the pateint 3) Taking developmental stages into consideration 4) Provide a chart of growth physical changes - correct answer ✅3) Taking developmental stages into consideration Pulmonary status findings of increased total lung capacity and residual volume in a 74-year-old patient are indicative of: 1) emphysema. 2) COPD 3) chronic bronchitis 2) Influenza 3) PNA 4) Hep B - correct answer ✅2) Influenza A patient with a diagnosis of diverticulosis presents with localized left lower quadrant discomfort, a palpable mass, mild leukocytosis, and T = 100° (37.8°C). The patient does not appear toxic and can tolerate fluids. An appropriate plan should include: 1) NPO, BARIUM enema 2) low fiber diet and referral to GI 3) clear liquids and oral antibiotics. 4) admit to hospital - correct answer ✅3) clear liquids and oral antibiotics. A frail elder who is on total bed rest suddenly develops urinary and fecal incontinence. This condition is frequently an indication of: 1) dementia. 2) fecal impaction. 3) cholecystitis. 4) parkinsons. - correct answer ✅2) fecal impaction. A 65-year-old female with diabetes mellitus presents for a routine follow up. BP is 142/88, Hgb A1c is 8.4%, fasting blood glucose is 160 mg/dL, and microalbumin is 60 mg/L (normal < 30 mg/L). In addition to changing the diabetes medications, the nurse practitioner would also ensure that the patient is taking: 1) nifedipine 12.5mg daily 2) Amlodipine 10mg daily 3) benazepril, 10 mg daily. 4) atenolol 25mg BID - correct answer ✅3) benazepril, 10 mg daily. A 67-year-old patient with type 2 diabetes mellitus, congestive heart failure (CHF), and mild coronary artery disease is currently taking digoxin, 0.25 mg daily; hydrochlorothiazide, 25 mg daily; glipizide, 10 mg daily; and atorvastatin (Lipitor), 20 mg h.s. Which of the following is an accurate statement regarding this regimen? 1) Glipizide will deplete potassium stores 2) The hydrochlorothiazide will predispose the patient to digoxin toxicity. 3) atorvastatin will worsen the diabetes - correct answer ✅2) The hydrochlorothiazide will predispose the patient to digoxin toxicity. An 18-year-old patient presents with complaints of maxillary facial pain and yellow nasal discharge for 14 days. What is the appropriate initial pharmacologic intervention? 1) Amoxicillin 2) Diphenhydramine 3) Doxycycline 4) erythromycin - correct answer ✅1) Amoxicillin Therapy for temporal arteritis would include: 1) Tylenol with codiene 2) ibuprofen 800mg TID 3) prednisone, 60 mg daily PO and re-evaluate in 1 month. - correct answer ✅3) prednisone, 60 mg daily PO and re-evaluate in 1 month. 3) have the patient share a room with a resident who has VRSA. 4) Delay discharge until the wound is clear - correct answer ✅2) have the patient share a room with a resident who also has MRSA. Which of the following laboratory tests are most widely accepted as indicators of the progression of HIV infection? 1) CD4 count and viral load 2) CD4 and Western Blot 3) CD4 and ELISA 4) WBC count and viral load - correct answer ✅1) CD4 count and viral load Which class of antihypertensive agents has been associated with acute renal failure, and is absolutely CONTRAINDICATED in patients with bilateral renal artery stenosis? 1) Thiazide diuretics 2) Angiotensin-converting enzyme (ACE) inhibitors 3) Calcium channel blockers 4) Potassium sparing diuretics - correct answer ✅2) Angiotensin-converting enzyme (ACE) inhibitors In geriatric patients, the polyvalent pneumococcal vaccine: 1) prevents or lessens the severity of 60%-70% of pneumococcal infections. 2) has no affect on immunocompromised patients 3) prevents pneumonia 100% of the time - correct answer ✅1) prevents or lessens the severity of 60%-70% of pneumococcal infections A 39-year-old patient was diagnosed with acute bronchitis in the emergency department and treated with acetaminophen, dextromethorphan, and metaproterenol (Alupent). The patient's history reveals a smoking habit of 1 pack per day. He now presents to your office with a fever of 101.2°F (39.4°C) and a cough productive of thick, yellow-green, foul-smelling sputum. You would encourage smoking cessation and prescribe: 1) a penicillin antibiotic 2) a macrolide antibiotic. 3) theophylline 4) inhalors - correct answer ✅2) macrolide antibiotic A 68-year-old female presents with a 3-week history of itching that increases in intensity at night. Red papules with scale crusts are noted on the axilla, groin, and interdigital webs of the hands. The most likely diagnosis is: 1) xerosis 2) herpes zoster 3) eczema 4) scabies. - correct answer ✅4) scabies A 68-year-old male with Parkinson's disease was placed on haloperidol (Haldol), 1 mg PO t.i.d. after presenting in the emergency department with visual and auditory hallucinations. On a visit to the office 2 days later for follow-up, the immediate course of action should be to: 1) decrease the dose of haloperidol. 2) prescribe a more potent neroleptic 3) discontinue the haloperidol. Which of the following statements about preventive health care for the elderly is incorrect? 1) Elderly people usually have adequate insurance coverage. 2) CALORIC needs are reduced in the elderly 3) femoral fractures are caused by uncoordinated muscle action than by the impact of the fall 4) Exercise EB to reduce mortality from CAD - correct answer ✅1) Elderly people usually have adequate insurance coverage. An 88-year-old presents with right-side weakness after being unable to rise unassisted following a fall to the bathroom floor. History includes aphasia and noncompliance with hypertension medication regimen. What is the most likely diagnosis? Left-sided or right-sided CVA? - correct answer ✅LEFT-SIDED CVA Which of the following signs/symtpoms are often associated with headahces due to intracranial tumor? 1) pain worse laying down, focal neurological signs 2) Hyperflexia, personality change 3) acute onset: hours to days 4) pupillary constriction; stupor - correct answer ✅1) pain worse laying down, focal neurological signs