AANP AGPCNP Exam Questions and Answers, Exams of Nursing

Download AANP AGPCNP Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! QUESTIONS AND ANSWERS Exam AANP AGPCNP EXAM QUESTIONS AND ANSWERS TESTED AND CONFIRMED A+ ANSWERS UPGRADED AANP AGPCNP EXAM QUESTIONS 1. An older adult presents with severe abdominal pain. The husband reports that earlier in the afternoon, the patient's abdominal hernia had been firm and bulged out 4 inches (10.2 cm). The patient had him press on the hernia and immediately felt burning pain throughout the abdomen. Which of the following is the nurse practitioners' NEXT action? 1. Abdominal CT scan 2. Complete blood count with differential 3. Abdominal ultrasound 4. Referral to the ED - CORRECT ANSWER -4. Referral to the ED 2. A young adult female who is 34 weeks pregnant presents with the complaint of urinary frequency every 1 to 2 hours. The patient has no fever and denies back pain. A urine dipstick test is positive for leukocyte esterase and nitrites. Microscopic analysis reveals 15-20 WBCs/hpf and a few bacteria. The BEST choice for treatment of this patient's urinary tract infection would be: 1. trimethoprim-sulfamethoxazole (Bactrim), 160 mg/800 mg twice daily for 3 days. 2. cephalexin (Keflex), 500 mg four times daily for 7 days. 3. ciprofloxacin (Cipro), 500 mg twice daily for 7 days. 4. erythromycin, 250 mg three times daily for 5 days. - CORRECT ANSWER -2. cephalexin (Keflex), 500 mg four times daily for 7 days. 3. An adult male presents with new-onset pain and tenderness in the low back and pain in the right great toe after a weekend of golf. He denies experiencing numbness and tingling. Which of the following would the nurse practitioner expect to find an investigation of this patient's low back pain? 1. Urge 2. Overflow 3. Transient 4. Stress - CORRECT ANSWER -1. Urge 10. A young adult female presents with painful swelling of the right cheek anterior to the TMJ. The diagnosis is sialadenitis. In addition to antibiotics, treatment for this patient should include: 1. hot soaks and lemon drops. 2. alternating heat and cold. 3. cold compresses and massage. 4. hot soaks and mucolytics. - CORRECT ANSWER -1. hot soaks and lemon drops. 11. Initial therapy for older adult patients with arthritic joints is: 1. naproxen, 1000 mg twice daily. 2. ibuprofen, 600 mg four times daily. 3. glucosamine, 750 mg twice daily. 4. acetaminophen, 1000 mg four times daily. - CORRECT ANSWER -4. acetaminophen, 1000 mg four times daily. 12. Which of the following is an example of gross negligence? 1. Prescription of a drug that causes a fatal allergic reaction 2. Misdiagnosis of appendicitis, resulting in peritonitis and a prolonged hospital stay 3. Refusal to return the emergency phone call of a patient who has chest pain evolving into an MI 4. Failure to diagnose a problem at an unrelated routine visit - CORRECT ANSWER -3. Refusal to return the emergency phone call of a patient who has chest pain evolving into an MI 13. What is the correct order of pharmacokinetics of drugs in the body? 1. absorption, distribution, metabolism, excretion 2. distribution, absorption, metabolism, excretion 3. absorption, metabolism, distribution, excretion 4. metabolism, distribution, absorption, excretion - CORRECT ANSWER -1. absorption, distribution, metabolism, excretion 14. An older adult female is brought in by her daughter, who has been visiting her. The daughter reports that her mother seems confused and anxious, and is moving oddly as if she is stiff. The daughter has brought along the mother's medications. She is taking hydrochlorothiazide, levothyroxine (Synthroid), sertraline (Zoloft), baby aspirin, a multivitamin, and St. John's wort. Which condition would the nurse practitioner MOST urgently suspect? 1. Alzheimer's disease 2. Serotonin syndrome 3. Vascular dementia 4. Aspirin toxicity - CORRECT ANSWER -2. Serotonin syndrome 15. An adolescent male presents with marked itching in the inguinal region but not on the scrotum. Examination shows a peripherally-spreading, sharply-demarcated, centrally-clearing, erythematous lesion. The MOST likely diagnosis is: 1. poor hygiene. 2. tinea versicolor. 3. pediculosis pubis. 4. tinea cruris. - CORRECT ANSWER -4. tinea cruris. 16. A young adult presents with a 3-day history of a sore throat, fever [102°F (38.9°C)], and malaise. Physical examination reveals posterior cervical lymphadenopathy and splenomegaly. A complete blood count (CBC) reveals a lymphocytosis. Which of the following patient care instructions is MOST appropriate? 1. Avoid strenuous activity and contact sports until advised. 2. Restrict symptomatic antipyretic therapy to acetaminophen. 3. Restrict symptomatic antipyretic therapy to NSAIDs. 4. Avoid close contact with others for 2 weeks. - CORRECT ANSWER -1. Avoid strenuous activity and contact sports until advised. 17. A nurse practitioner is treating an adult with iron deficiency anemia. At what point would the hematocrit level be expected to return to baseline? 1. 3 weeks 2. 2 months 3. 6 months 4. 1 year - CORRECT ANSWER -2. 2 months 18. An older adult complains of fatigue, stiffness in the shoulders and neck, recent onset of temporal headache, and an episode of transient visual loss in one eye. Erythrocyte sedimentation rate (ESR) is 72 mm/h [normal value = <15 mm/h]. These findings are consistent with: 1. migraine headache. 2. glaucoma. 3. giant cell (temporal) arteritis. 1. Diastolic murmur 2. Systolic ejection murmur 3. Pericardial friction rub 4. Third heart sound - CORRECT ANSWER -4. Third heart sound 26. An elderly male farmer presents with an oval, pearly nodule, 0.6 inch (1.5 cm) long, on the lower eyelid. The lesion has a rolled, translucent border and is surrounded by multiple small telangiectasias. The MOST likely diagnosis is: 1. actinic keratosis. 2. chancre of syphilis. 3. dermatofibroma. 4. basal cell carcinoma. - CORRECT ANSWER -4. basal cell carcinoma. 27. Which of the following is the MOST common type of hearing loss in older adults? 1. Otitis media 2. Heredity 3. Conductive 4. Sensorineural - CORRECT ANSWER -4. Sensorineural 28. An elderly male who is a pipe smoker presents with a non-healing ulcerative lesion of the lower lip. Biopsy of the lesion reveals squamous cell carcinoma. What is the INITIAL recommendation for management? 1. Surgical excision 2. Radiation therapy 3. Chemotherapy 4. Watchful waiting - CORRECT ANSWER -1. Surgical excision 29. An older adult female presents with loss of appetite and dark stools. Physical examination of the abdomen produces normal results. Rectal examination reveals stools positive for blood. Current medications include a calcium channel blocker, a selective serotonin reuptake inhibitor, a bisphosphonate, and a statin. Which medication should be held until an evaluation can be completed? 1. Statin 2. Bisphosphonate 3. Selective serotonin reuptake inhibitor 4. Calcium channel blocker - CORRECT ANSWER -2. Bisphosphonate 30. Which of the following are risk factors for the development of osteoporosis? 1. High caffeine intake, hypertension, and breastfeeding 2. Smoking, diabetes mellitus, and low calcium intake 3. Drinking fluoridated water, hypothyroidism, and excess exercise 4. Early menopause, low calcium intake, and low body weight - CORRECT ANSWER -4. Early menopause, low calcium intake, and low body weight 31. A man calls to report that his elderly wife awakened this morning with confusion, slurred speech, and paresthesia of her right arm and leg. Although no prior episodes of these symptoms have been reported, the woman's medical history reveals that she has diabetes and hypertension. At present, her symptoms have resolved. Based on the symptoms reported, what is the MOST likely diagnosis? 1. Hypoglycemic episode 2. Hypothyroidism 3. Right-sided CVA 4. Transient ischemic attack - CORRECT ANSWER -4. Transient ischemic attack 32. An older adult with a history of hypertension and atrial fibrillation is brought to the ED after a fall. She is diagnosed with a fracture of the neck of the left femur and has left open reduction internal fixation (ORIF). She is discharged for rehabilitation on enoxaparin (Lovenox), 30 mg SC twice daily. On the third day of rehabilitation, she reports increased swelling and tightness of the left leg. She is hospitalized for acute respiratory distress and placement of a Greenfield filter. The usual indication for this filter is: 1. prevention of cerebral embolism. 2. atrial fibrillation. 3. clot migration. 4. venous insufficiency. - CORRECT ANSWER -3. clot migration. 33. Which of the following symptoms of depression is more commonly seen in older adults rather than younger adults? 1. Cognitive impairment 2. Loss of interest in usual activities 3. Inattention to personal hygiene 4. Hopelessness - CORRECT ANSWER -1. Cognitive impairment 34. A young adult with a history of allergic rhinitis presents with facial pain, congestion, eye pain, and fatigue. She has frontal sinus tenderness and yellow nasal discharge. Chart review reveals that she has completed two courses of amoxicillin (Amoxil) within the past 30 days. Which action should the nurse practitioner take? 1. Prescribe oral corticosteroids. 3. T 3 -T 4. 4. cholesterol. - CORRECT ANSWER -1. thyroid-stimulating hormone (TSH). 41. An elderly female has been living with her 70-year-old, widowed daughter and granddaughter. The patient's daughter schedules an appointment with a nurse practitioner to "discuss a few things." She reports that she now has sole responsibility for the care of her mother, because her daughter has moved out of state. As the patient's daughter talks, she begins to cry. She does not want to put her mother into a nursing facility, but feels unable to continue to care for her alone. Which of the following is the BEST initial step in assisting this patient? 1. Refer the patient's daughter to a social worker for counseling. 2. Discuss community resources available to provide assistance and respite care. 3. Review placement options. 4. Call the granddaughter to discuss the situation. - CORRECT ANSWER -2. Discuss community resources available to provide assistance and respite care. 42. An elderly patient with Stage 4 heart failure, severe COPD, and end-stage renal disease reports feeling very hopeless and says he is "close to death." What is the MOST appropriate intervention for this patient? 1. Discuss an antidepressant with the patient and family. 2. Explore the option of referring the patient to a hospice program. 3. Use motivational interviewing to help patient feel more hopeful. 4. Refer the patient to the activities coordinator for diversional activities. - CORRECT ANSWER -2. Explore the option of referring the patient to a hospice program. 43. A healthy, older adult male has just had a normal yearly physical in a nurse practitioner's clinic. The patient has no chronic illnesses, and all results from screening tests performed in the clinic are normal. The BEST advice the practitioner can give is that it is: 1. important to undergo a dilated funduscopic examination every 1-2 years. 2. acceptable to delay examination by an ophthalmologist. 3. not necessary to undergo an examination. 4. particularly important to undergo an examination to evaluate for presbyopia. - CORRECT ANSWER -1. important to undergo a dilated funduscopic examination every 1-2 years. 44. An older adult presents with left-side "rib pain" the past few days, headache, a feverish feeling, and general malaise. Physical examination reveals an area of papular eruptions with a few vesicles on the left side of the chest. What is the MOST likely cause of the patient's symptoms? 1. Herpes zoster 2. Eczema 3. Intertrigo 4. Actinic keratosis - CORRECT ANSWER -1. Herpes zoster 45. A young adult presents with a 1-week history of excessive thirst, excessive urination, and persistent hunger. There is concern because the patient's grandmother had the same symptoms and was diagnosed with diabetes mellitus. The patient reports some nausea and flu-like sensations. On the basis of this information, which of the following tests would be MOST critical to the immediate diagnosis and treatment? 1. 24-hour creatinine 2. Serum glucose 3. 3-hour glucose tolerance test 4. Serum amylase - CORRECT ANSWER -2. Serum glucose 46. An older adult female reports pain with intercourse. Following inspection of the genitalia, the nurse practitioner's initial plan of care would be to: 1. start vaginal hormone cream. 2. start low-dose hormones. 3. advise use of vaginal lubricants. 4. refer to a gynecologist for vaginal evaluation. - CORRECT ANSWER -3. advise use of vaginal lubricants 47. An older adult presents with angina, dyspnea on exertion, and syncope. Examination reveals a delay in carotid upstroke, a paradoxically split S2 heart sound, and a harsh systolic murmur. Which of the following is the MOST likely diagnosis? 1. Aortic regurgitation 2. Aortic stenosis 3. Mitral valve prolapse 4. Chordae tendineae rupture - CORRECT ANSWER -2. Aortic stenosis 48. A nurse practitioner is examining an adult male who has pain in his right hand. The patient fell onto his outstretched hand, jamming his thumb. He has pain in the "snuffbox" area. The patient's X-ray is negative. An appropriate follow-up evaluation would be to: 1. place the wrist in a universal wrist splint for 6 weeks. 2. check for full ROM in 3 days. 3. evaluate strength return in 1 week. 4. X-ray the wrist again in 2 weeks. - CORRECT ANSWER -4. X-ray the wrist again in 2 weeks. 49. NSAIDs should be used with caution in the elderly because of the potential for causing: 1. bradykinesia. 2. acute renal failure. 4. Anterior cruciate ligament damage - CORRECT ANSWER -4. Anterior cruciate ligament damage 56. A young adult female presents because she fainted while in the bathroom putting on makeup. She recalls awakening on the floor but remembers nothing prior to awakening other than putting on makeup. She is alert, oriented, and afebrile. BP = 120/70, P = 72, R = 16/min. The NEXT step in the evaluation of this syncopal episode is: 1. radiographic testing. 2. a detailed health history. 3. a complete physical examination. 4. laboratory testing. - CORRECT ANSWER -2. a detailed health history. 57. In addition to a complete blood count (CBC) which of the following diagnostic labs are included in the workup for dementia in an older adult? 1. Three blood cultures and magnesium 2. Creatinine and alkaline phosphate 3. Thyroid-stimulating hormone (TSH) and CMP 4. Alkaline phosphate and magnesium - CORRECT ANSWER -3. Thyroid-stimulating hormone (TSH) and CMP 58. An adult presents with wheezing, dyspnea, "tight chest," tachycardia, chills, and nausea. The patient was diagnosed 2 weeks ago with hemorrhagic tonsillitis and treated with cephalexin (Keflex), followed by ciprofloxacin (Cipro). Diagnostic/laboratory assessment findings include: white blood count (WBC) = 22,500/μL (22.5 × 109/L); sputum culture shows Gram-positive cocci; chest X-ray shows right lower lobe infiltrates. Based on these findings, which of the following is the MOST appropriate diagnosis? 1. Right lower lobe atelectasis 2. Mycoplasma pneumoniae infection 3. Streptococcus pneumoniae infection 4. Methicillin-resistant Staphylococcus aureus - CORRECT ANSWER -3. Streptococcus pneumoniae infection 59. An adult female who just became insured presents for an initial visit. She has been sexually active for at least 10 years, but has never had a Pap smear. The nurse practitioner assesses for higher risk of cervical intraepithelial neoplasia (CIN). Which of the following is MOST important to include in the history? 1. Number of previous pregnancies 2. Age of menarche 3. Number of sexual partners 4. Herpes infections - CORRECT ANSWER -3. Number of sexual partners 60. What does a nurse practitioner tell an adult patient who presents with 3 days of nasal drainage and sinus pressure who wants antibiotics? 1. Antibiotics will be prescribed for 7 days to prevent the patient from being contagious. 2. Antibiotics are not indicated unless the symptoms have been present for 14 days or have worsened. 3. Prednisone will be prescribed to decrease the swelling inside the nose and decrease drainage. 4. A CT scan will be ordered in order to diagnose an acute rhinosinusitis. - CORRECT ANSWER -2. Antibiotics are not indicated unless the symptoms have been present for 14 days or have worsened. 61. Prior to initiating thiazide diuretics for a new patient with hypertension, which of the following is the MOST important baseline data? 1. Chest X-ray 2. Electrolytes 3. Urinalysis 4. EKG - CORRECT ANSWER -2. Electrolytes 62. An elderly nursing facility resident has had a cough for the past month. The patient has been treated with prednisone for wheezing. A tuberculosis test administered one year ago was negative. In addition to a chest X-ray, which is the NEXT BEST test to order? 1. Complete blood count (CBC) 2. Interferon gamma release assay (IGRA) 3. Sputum culture 4. Tuberculin tine test - CORRECT ANSWER -2. Interferon gamma release assay (IGRA) 63. Neurological symptoms of pernicious anemia are: 1. loss of coordination and fine motor control. 2. focal seizures and loss of coordination. 3. muscle weakness and paralysis. 4. headaches and muscle weakness. - CORRECT ANSWER -1. loss of coordination and fine motor control 64. The MOST likely suspected diagnosis in an elderly patient who has been exhibiting a progressive decline in cognitive status would be: 1. an occult infection. 2. myocardial infarction. 3. Alzheimer's dementia. 71. A nurse practitioner suspects that an older adult, obese patient may have obstructive sleep apnea. The patient cannot afford a sleep study. Screening of this patient for sleep apnea could be completed by: 1. spot pulse oximetry. 2. home nocturnal pulse oximetry. 3. echocardiography. 4. arterial blood gases. - CORRECT ANSWER -2. home nocturnal pulse oximetry. 72. Which factor carries the HIGHEST risk for breast cancer? 1. Age at first live birth 2. Age at menopause 3. Use of oral contraceptives 4. First-degree female relative - CORRECT ANSWER -4. First-degree female relative 73. An older adult male comes to the clinic having had bright red rectal bleeding for the past 2 weeks. There is no family history of colon cancer. He denies weight loss, abdominal pain, or changes in stool color or shape. The patient recently had an episode of constipation that was relieved by over-the-counter laxatives. Which of the following diagnostic procedures would be completed FIRST? 1. Abdominal ultrasound 2. Barium colon X-ray 3. CT scan 4. Colonoscopy - CORRECT ANSWER -4. Colonoscopy 74. Routine cervical Papanicolaou screening is categorized as which type of prevention? 1. Primary 2. Secondary 3. Tertiary 4. Routine - CORRECT ANSWER -2. Secondary 75. An elderly female presents with postmenopausal bleeding. The MOST likely diagnosis is: 1. endometriosis. 2. uterine leiomyoma. 3. endometrial carcinoma. 4. vulvar carcinoma. - CORRECT ANSWER -3. endometrial carcinoma.