AANP AGPCNP PRACTICE questions and answers rated A, Exams of Nursing

Download AANP AGPCNP PRACTICE questions and answers rated A and more Exams Nursing in PDF only on Docsity! AANP AGPCNP PRACTICE questions and answers rated A 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 Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion? 1) Timolol AANP AGPCNP PRACTICE questions and answers rated A 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 AANP AGPCNP PRACTICE questions and answers rated A 4) COntinue NSAID, xray and add a metatarsal bar - correct answer ✅2) continue NSAID, apply an arch support and encourage wt loss and exercise Fundoscopic exam of Hypertensive patient. 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 - correct answer ✅1) nicking of arteriols and viens, and small retinol hemorrages Which of the following is a common presenting feature of hyperthyroidism in the elderly? 1) elevated TSH 2) Thyroid enlargement 3) atrial fibrillation 4) abnormal T3 suppression - correct answer ✅3) atrial fibrillation AANP AGPCNP PRACTICE questions and answers rated A 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 AANP AGPCNP PRACTICE questions and answers rated A 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 AANP AGPCNP PRACTICE questions and answers rated A 1) Bactrim 2) azithromycin 3) doxycycline (Doryx). 4) metronidazole - correct answer ✅3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with WEstern Blot) 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 - correct answer ✅2) 126 mg/dl In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves: AANP AGPCNP PRACTICE questions and answers rated A 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: AANP AGPCNP PRACTICE questions and answers rated A 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? AANP AGPCNP PRACTICE questions and answers rated A 3) renal function 4) mental state - correct answer ✅1) coronary status Which of the following would be most appropriate to perform in the initial evaluation of a patient with symptoms of acute prostatitis? 1) Prostate-specific antigen (PSA) 2) Urinalysis and urine culture 3) Scrotal massage and urine sample 4) CBC with diff - correct answer ✅2) urinalysis and urine culture Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis? 1) Organisms about the size of white blood cells with undulating flagellum, occasional lactobacillus, many white blood cells AANP AGPCNP PRACTICE questions and answers rated A 2) Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells 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° AANP AGPCNP PRACTICE questions and answers rated A 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 AANP AGPCNP PRACTICE questions and answers rated A 2) ask what they would do if there was a fire in the house 3) count backwards by 7's - correct answer ✅1) the meaning of a common proverb A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouth that do not rub off when wiped with a 4 × 4. The patient should be evaluated for: 1) lichen planus 2) HIV infection. 3) lymphoma 4) Candida lingua - correct answer ✅2) HIV infection (hairy luekaplakia-immune) A 70-year-old patient presents with complaints of vague epigastric pain occurring at night, causing early morning awakening, and decreased appetite 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. AANP AGPCNP PRACTICE questions and answers rated A 2) taking off from work until the work-up is complete. 3) Reporting nausea/vomiting 4) Discontinue NSAIDS - correct answer ✅2) taking off work until the work-up is complete A 32-year-old patient reports a 6-month history of intermittent symmetrical 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 - 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 AANP AGPCNP PRACTICE questions and answers rated A 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 AANP AGPCNP PRACTICE questions and answers rated A 3) pneumococcal vaccine, 0.5 mL IM. - correct answer ✅2) influenza vaccine, 0.5 mL IM, and pneumococcal vaccine, 0.5 mL IM. An 87-year-old patient is being treated for major depression with a selective serotonin reuptake inhibitor. Which of the following would have the greatest probability of remaining in the serum long after being discontinued? 1) Celexa 2) Prozac 3) Paxil 4) Zoloft - correct answer ✅2) Fluoxetine (Prozac) Age-related macular degeneration leads to which of the following? 1) Loss of central vision 2) Loss of peripheral vision 3) hemianopsia bilateral - correct answer ✅1) loss of central vision AANP AGPCNP PRACTICE questions and answers rated A The approved therapeutic International Normalized Ratio (INR) for a patient on warfarin (Coumadin) therapy for atrial fibrillation is: 1) 1.0-2.0 2) 2.0-3.0 3) 2.5-3.5 - correct answer ✅2) 2.0-3.0 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 - 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). AANP AGPCNP PRACTICE questions and answers rated A 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 AANP AGPCNP PRACTICE questions and answers rated A 1) just do a physical assessment, not social 2) make an assessment of battering. 3) avoid making a battering assessment, it is legal - correct answer ✅2) make an assessment of battering. Over the past 6 months, a nurse practitioner has been treating a 62-year-old construction worker for chronic/recurrent right biceps tendonitis. 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 - correct answer ✅2) for the presence of right upper arm bulge ("Popeye muscle") and biceps strength. AANP AGPCNP PRACTICE questions and answers rated A Which of the following accurately describes the phenomenon of isolated systolic hypertension, as opposed to isolated diastolic or combined systolic/diastolic hypertension, in the elderly? 1) Considered a significant risk factor for MI or stroke 2) demonstrated to be related to smoking 3) Occurs primarily in men 4) Not considered to be a major risk - correct answer ✅1) Considered a significant risk factor for MI or stroke An 87-year-old long-term care facility resident was hospitalized for an abdominal surgery procedure, and the incision has become infected with methicillin-resistant Staphylococcus aureus (MRSA). The hospital is planning to return the patient to the same facility, which has no private rooms. According to CDC guidelines, the alternative placement would be to: 1) inform the hospital that the patient will have to go to another facility. 2) have the patient share a room with a resident who also has MRSA. AANP AGPCNP PRACTICE questions and answers rated A 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 AANP AGPCNP PRACTICE questions and answers rated A 1) decrease the dose of haloperidol. 2) prescribe a more potent neroleptic 3) discontinue the haloperidol. 4) add SSRI - correct answer ✅3) discontinue the halperidol 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. 3) irrigate the eye 4) perform a fundoscopic exam - correct answer ✅2) check for visual acuity Which of the following is considered the most important factor in understanding and predicting an individual's health across the life span? 1) Psychological profile AANP AGPCNP PRACTICE questions and answers rated A 2) Body habitus 3) Family history 4) diet history - correct answer ✅3) family history A 68-year-old patient with a recent diagnosis of mild transient ischemic attack has been placed on aspirin, 325 mg PO daily with food. The patient develops an aspirin allergy. You would discontinue aspirin and: 1) change to clopidogrel (Plavix). 2) change to valproic acid 3) refer for endoarectomy 4) change to bulibital - correct answer ✅1) change to clopidorel An 85-year-old female presents with a 2-hour history of diminished vision and severe pain in the right eye, plus nausea and vomiting. Visual acuity is decreased, the left pupil reacts to light, the right pupil does not react to light, and the conjunctiva is injected. The nurse practitioner would: AANP AGPCNP PRACTICE questions and answers rated A 1) immediately refer to an ophthalmologist. 2) administer steroids 3) complete a comprehensive eye vision test 4) administer pilotarpine eye drops - correct answer ✅1) immediately refer to an ophthalmologist. (acute angle closure glaucoma) 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.