AANP AGPCNP PRACTICE 75 QUESTIONS WITH CORRECT ANSWERS (DOWNLOAD FOR AN A+), Exams of Nursing

Download AANP AGPCNP PRACTICE 75 QUESTIONS WITH CORRECT ANSWERS (DOWNLOAD FOR AN A+) and more Exams Nursing in PDF only on Docsity! pg. 0 0 AANP AGPCNP PRACTICE 75 QUESTIONS WITH CORRECT ANSWERS (DOWNLOAD FOR AN A+) 1. 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?: LEFT-SIDED CVA 2. 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: 1) pain worse laying down, focal neurological signs 3. Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion? 1) Timolol 2 / 18 2) Discontinue use 3 / 18 1) nicking of arteriols and viens, and small retinol hemorrages 2) drusen bodies and pale retina 3) pale macula and swollen disk margins 4) microaneurysms and optic disc cupping: 1) nicking of arteriols and viens, and small retinol hemorrages 11. Which of the following is a common presenting feature of hyperthy- roidism in the elderly? 1) elevated TSH 2) Thyroid enlargement 3) atrial fibrillation 4) abnormal T3 suppression: 3) atrial fibrillation 12. 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 1) green penile discharge 2) uticartia 3) unremarkable symtpoms 4) penile ulcer: 3) unremarkable symptoms 18. 37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be: 1) spirometry 2) MRI 3) COntract venogra[hy 4) helical CT pulmonary angiograph: 4) helical CT pulmonary angiography. 19. A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly irregular R-R interval. This arrhythmia is: 1) atrial flutter 2) atrial fibrillation 3) second degree heart block 4) Wolff-White Syndrome: 2) atrial fibrillation 20. After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing, located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes: 1) Bactrim 2) azithromycin 3) doxycycline (Doryx). 4) metronidazole: 3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with WEstern Blot) 21. According to the American Diabetes Association, the newest standard for determining the presence of diabetes mellitus based on fasting plasma sugar level is a value equal to or greater than: 1) 110 mg/dL. 2) 126 mg/dL. 3) 135 4) whatever: 2) 126 mg/dl 3) needing more insulin in the mornings 4) Need to increase insulin at night: 2) Somogyi effect 26. In a healthy elder, which of the following TRADITIONALLY defines a positive urine culture? 1) e100,000 colonies/mL of a single organism 2) e10,000 colonies/mL of a single organism 3) e100,000 colonies/mL of a two or more organisms: e100,000 colonies/mL of a single organism 27. 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: 3) parathyroid hormone level 28. 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 pain, dyspnea, or diaphoresis. She exhibits mild anxiety and reluctance to change position or turn the head. BP = 126/76; P = 78; R = 16/min; and T = 98.2°F (36.8°C). HEENT examination reveals 17 beats of horizontal nystagmus on right lateral gaze; the nystagmus stops after several repetitions of the maneuver. Funduscopic, cardiac, pulmonary, abdominal, and neurologic examination results are normal. The most likely diagnosis is: 1) acoustic neuroma 2) vestibular neuritis. 3) vertibailar insufficiency 4) TIA: 2) vestibular neuritis 29. When initiating thyroid hormone replacement in the older adult, care must be taken to evaluate the patient's: ders, no lactobacillus rods, many white blood cells 3) Squamous epithelial cells with stippling appearance and indistinct bor- ders, many lactobacillus rods, few white blood cells: 2) Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells 32. Which of the following physical findings would best alert a nurse practi- tioner 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, posi- tive straight-leg raise at 30° 3) Negative Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 80°: 2) Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30° 33. 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: 1) calf circumference and perform Doppler studies 34. 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: 2) Aqua exercises 35. Trigeminal neuralgia 1) electric shock like unilateral pain 2) jaw pain extending to the neck 3) Bilateral burning pain: 1) electric shock like unilateral pain 36. 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: 2) orthostatic hypotension 37. 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: 2) due to dehydration 41. A 70-year-old patient presents with complaints of vague epigastric pain occurring at night, causing early morning awakening, and decreased ap- petite with early satiety. Significant history includes recent use of ibuprofen for headaches. Rectal examination was negative. While awaiting the results of ordered diagnostic tests, the practitioner should recommend all of the following EXCEPT: 1) starting H2 blockers. 2) taking off from work until the work-up is complete. 3) Reporting nausea/vomiting 4) Discontinue NSAIDS: 2) taking off work until the work-up is complete 42. A 32-year-old patient reports a 6-month history of intermittent symmetri- cal swelling of the wrists and daily morning stiffness lasting 1 hour or more in and around other joints. What is the most likely diagnosis? 1) Rheumatoid arthritis 2) Osteoarthritis 3) Gouty arthritis: 1) Rheumatoid arthritis 43. 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: 4) Feverfew 44. 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: 1) Streptococcus pneumoni- ae and Haemophilus influenzae. 45. Which cranial nerves test the oculomotor eye movement and strabis- mus? 1) CN I III, IV 2) CV III, IV and VI 3) CN III, V, VII: 2) CV III, IV and VI 46. The management of COPD in the elderly is best guided by: 1) pulse oximetry 2) arterial blood gases 3) radiographic images 4) symptomology: 4) symptomology 47. Which of the following is the most serious outcome of Barrett's esopha- gus? 1) Esophageal adenocarcinoma 2) esophageal varices 3) GERD 1) influenza vaccine, 0.5 mL IM, 2) influenza vaccine, 0.5 mL IM, and pneumococcal vaccine, 0.5 mL IM. 3) pneumococcal vaccine, 0.5 mL IM.: 2) influenza vaccine, 0.5 mL IM, and pneumococcal vaccine, 0.5 mL IM. 51. An 87-year-old patient is being treated for major depression with a se- lective serotonin reuptake inhibitor. Which of the following would have the greatest probability of remaining in the serum long after being discontin- ued? 1) Celexa 2) Prozac 3) Paxil 4) Zoloft: 2) Fluoxetine (Prozac) 52. Age-related macular degeneration leads to which of the following? 1) Loss of central vision 2) Loss of peripheral vision 3) hemianopsia bilateral: 1) loss of central vision 53. The approved therapeutic International Normalized Ratio (INR) for a pa- tient on warfarin (Coumadin) therapy for atrial fibrillation is: 1) 1.0-2.0 2) 2.0-3.0 3) 2.5-3.5: 2) 2.0-3.0 54. A 57-year-old patient presents for a physical examination. The patient has been in good health, takes no medications, has a family history of hypertension and heart disease, denies alcohol use, and has never smoked. The patient's last tetanus booster was 9 years ago. Which of the following vaccines is indicated at this time? 1) TD 2) Influenza 3) PNA 4) Hep B: 2) Influenza 55. A patient with a diagnosis of diverticulosis presents with localized left lower quadrant discomfort, a palpable mass, mild leukocytosis, and T = 59. An 18-year-old patient presents with complaints of maxillary facial pain and yellow nasal discharge for 14 days. What is the appropriate initial phar- macologic intervention? 1) Amoxicillin 2) Diphenhydramine 3) Doxycycline 4) erythromycin: 1) Amoxicillin 60. 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.: 3) prednisone, 60 mg daily PO and re-evaluate in 1 month. 61. In addressing suspected domestic violence in an adult relationship, it is appropriate to: 1) just do a physical assessment, not social 2) make an assessment of battering. 3) avoid making a battering assessment, it is legal: 2) make an assessment of battering. 62. Over the past 6 months, a nurse practitioner has been treating a 62-year-old construction worker for chronic/recurrent right biceps ten- donitis. He has had good and bad days, but seems to respond well to NSAIDs and muscle relaxants. Today he returns to the clinic after feeling a "snapping" sensation in his right upper arm while lifting a cinder block. To aid in diagnosis, the nurse practitioner would evaluate: 1) Right shoulder ROM, and strength 2) for the presence of right upper arm bulge ("Popeye muscle") and biceps strength. 3) radial pulses and right biceps tendon 4) right supination/pronation: 2) for the presence of right upper arm bulge ("Popeye muscle") and biceps strength. 63. Which of the following accurately describes the phenomenon of isolated systolic hypertension, as opposed to isolated diastolic or combined sys- tolic/diastolic hypertension, in the elderly? 1) Considered a significant risk factor for MI or stroke 3) prevents pneumonia 100% of the time: 1) prevents or lessens the severity of 60%-70% of pneumococcal infections 68. A 39-year-old patient was diagnosed with acute bronchitis in the emer- gency 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: 2) macrolide antibiotic 69. A 68-year-old female presents with a 3-week history of itching that in- creases 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.: 4) scabies 70. 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. 4) add SSRI: 3) discontinue the halperidol 71. A 70-year-old farmer was hit in the eye with a tree branch. The first step in the assessment of a possible corneal abrasion is to: 1) check for pupillary reaction. 2) measure visual acuity.