2024 AANP AGPCNP PSI Test 1 & 2 Q&A: Nursing Practice for Certification Exam, Exams of Nursing

Download 2024 AANP AGPCNP PSI Test 1 & 2 Q&A: Nursing Practice for Certification Exam and more Exams Nursing in PDF only on Docsity! AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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/symptoms are often associated with headaches due to intracranial tumor? 1) pain worse laying down, focal neurological signs 2) Hyperlexia, 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? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 1) stop NSAID, apply a heel cup and encourage exercise and wt loss. 2) continue NSAID, apply an arch support and encourage wt loss and exercise 3) continue NSAID, xray and add a short-leg night splint 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? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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: AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 1) atrial flutter 2) atrial fibrillation 3) second degree heart block 4) Wolff-White Syndrome - Correct Answer 2) atrial fibrillation 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 - Correct Answer 3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with WEstern Blot) AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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: 1) decreased cardiac output. 2) loss of vascular tissue elasticity. 3) hyperactive baroreceptors - Correct Answer 2) loss of vascular tissue elasticity AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 - Correct Answer 2) vestibular neuritis When initiating thyroid hormone replacement in the older adult, care must be taken to evaluate the patient's: 1) coronary status. 2) weight 3) renal function AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 PSI Test 1 & 2 Questions with Answers 2024 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 PSI Test 1 & 2 Questions with Answers 2024 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 Office spirometry performed with an albuterol nebulizer treatment can confirm a diagnosis of asthma because it indicates: 1) a patient has pulmonary fibrosis 2) chronic carbon dioxide retension 3) if a patient has reversible airway obstruction. - Correct Answer 3) if a patient has reversible airway obstruction. To assess ability to reason abstractly, you would ask the patient to: AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 1) the meaning of a common proverb 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: AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 1) starting H2 blockers. 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 3) chronic bronchitis 4) Asthma - Correct Answer 1) emphysema A 65-year-old patient with hypertension and associated angina requests a flu vaccine. The patient had a pneumococcal vaccine 10 years ago. The most appropriate plan of care would include: 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. - 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. 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 - Correct Answer 2) make an assessment of battering. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. 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? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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: AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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: AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. Exacerbation of extremity symptoms with straight-leg raising 2. Loss of bowel and bladder function 3. Increased ankle jerk on evaluation of deep tendon reflexes 4. Increased lumbar lordosis - Correct Answer 1. Exacerbation of extremity symptoms with straight-leg raising 4. A true statement about essential tremors is that they: AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 1. often begin with "pill-rolling" of one hand and may affect the legs, feet, and toes. 2. are often barely visible, rapid tremors. 3. are a characteristic of Parkinson's disease. 4. are slow tremors that are absent or minimal at rest and usually involve the hands. - Correct Answer 4. are slow tremors that are absent or minimal at rest and usually involve the hands. 5. Which opioid medication is the MOST potent? 1. Codeine 2. Morphine 3. Oxycodone 4. Hydromorphone - Correct Answer 4. Hydromorphone 6. Which symptom documented in a menstrual diary is diagnostic of PMS? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 2. ductal lavage. 3. fine-needle aspiration. 4. MRI. - Correct Answer 3. fine-needle aspiration. 20. Which of the following drugs is the BEST choice for prevention of coronary artery disease in elderly patients? 1. Enteric-coated ASA 2. Warfarin (Coumadin) 3. Dipyridamole-ASA (Aggrenox) 4. Clopidogrel (Plavix) - Correct Answer 1. Enteric-coated ASA 21. An older adult presents with 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. Which is the MOST likely diagnosis? 1. Gastroparesis AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 2. Reflux esophagitis 3. Duodenal ulcer 4. Crohn's disease - Correct Answer 3. Duodenal ulcer 22. An older adult female is diagnosed with urge urinary incontinence. The patient is alert and cognitively intact. The MOST appropriate management is: 1. urinating frequently to avoid urgency. 2. bladder retraining. 3. wearing protective garments, such as continence pads. 4. reducing fluid intake to four 8-oz glasses a day. - Correct Answer 2. bladder retraining. 23. Which of the following asymptomatic skin conditions can an older adult manage at home? 1. Actinic keratosis 2. Basal cell lesions AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 3. Seborrheic keratosis 4. Squamous cell lesions - Correct Answer 3. Seborrheic keratosis 24. The MOST common bacterial cause of cellulitis in patients with diabetes mellitus is: 1. group A beta-hemolytic Streptococcus. 2. Vibrio vulnificus. 3. Pseudomonas aeruginosa. 4. Staphylococcus aureus. - Correct Answer 4. Staphylococcus aureus. 25. An adult with coronary artery disease has had angioplasty twice, as well as a two-vessel bypass graft. The patient presents with increasing shortness of breath, dyspnea on exertion, paroxysmal and nocturnal dyspnea, and mild edema of the lower extremities. Which of the following findings is MOST likely? 1. Diastolic murmur 2. Systolic ejection murmur AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. 2. Transilluminate the sinuses. 3. Change the antibiotic to amoxicillin-clavulanic acid (Augmentin). 4. Refer the patient to ENT and/or an allergist. - Correct Answer 4. Refer the patient to ENT and/or an allergist. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 39. A patient presents with unilateral ear pain of 1-week duration, nasal congestion, and a sore throat. Physical examination reveals an opaque, hypomobile left tympanic membrane. The nurse practitioner performs a tuning fork test, expecting to find that the: 1. Weber test shows lateralization to the left. 2. air conduction threshold is greater than bone conduction on the left. 3. air conduction threshold is less than bone conduction on the right. 4. Weber test shows lateralization to the right. - Correct Answer 1. Weber test shows lateralization to the left. 40. An adult female was recently diagnosed with hypothyroidism. The nurse practitioner starts the patient on levothyroxine (Synthroid). In evaluating proper treatment of this patient, the MOST appropriate laboratory test the nurse practitioner should order is: 1. thyroid-stimulating hormone (TSH). 2. follicle-stimulating hormone (FSH). AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 49. NSAIDs should be used with caution in the elderly because of the potential for causing: 1. bradykinesia. 2. acute renal failure. 3. hypotensive crisis. 4. pulmonary fibrosis. - Correct Answer 2. acute renal failure. 50. "Natural" weight loss products may be extremely harmful to patients with potential cardiac problems if the products contain: 1. ephedrine sulfate. 2. St. John's wort. 3. kava kava. 4. melatonin. - Correct Answer 1. ephedrine sulfate. AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 51. A patient with hypertension has a normal serum uric acid level. The patient is currently taking hydrochlorothiazide (HCTZ), 25 mg PO daily. The patient's blood pressure is very well controlled, and there are no symptoms of gout. In this situation, the nurse practitioner should: 1. get a 24-hour urine for uric acid determination. 2. discontinue the hydrochlorothiazide. 3. start the patient on allopurinol (Zyloprim), 300 mg PO daily. 4. continue the patient on the same medication. - Correct Answer 4. continue the patient on the same medication. 52. An elderly patient with a history of smoking presents with increased pedal edema and dyspnea on exertion. The patient has a long history of poorly controlled blood pressure on physical examination. The nurse practitioner hears an S4 gallop and orders an echocardiogram. The results show an ejection fraction of 35%. Which diagnosis is MOST descriptive of these signs and symptoms? 1. Congestive heart failure AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 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 AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 2. perforated duodenal ulcer. 3. acute cholecystitis. 4. acute pancreatitis. - Correct Answer 4. acute pancreatitis. 66. A young adult male is triaged to the fast-track area to repair a cut on his third digit. The injury occurred while he was deboning a chicken. In addition to evaluating the finger for tendon rupture and foreign body, an important component of his treatment should include which of the following? 1. Assessing tetanus immunization status 2. Scrubbing the wound with Betadine solution 3. Assessing for salmonella infection 4. Irrigating vigorously with sterile water - Correct Answer 1. Assessing tetanus immunization status 67. Which of the following would a nurse practitioner expect to find in a patient with bacterial vaginosis? AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 1. Positive "whiff" test 2. Anal pruritus 3. Frequent urination 4. pH < 4.5 - Correct Answer 1. Positive "whiff" test 68. What is the MOST important aspect of health promotion and disease prevention in the elderly? 1. Minimizing the impact of disease on functioning 2. Preventing the occurrence of disease 3. Preventing age-related changes in the immune system 4. Minimizing the occurrence of risky behaviors - Correct Answer 1. Minimizing the impact of disease on functioning 69. An older adult is taking multiple medications for hypertension, hyperlipidemia, and COPD. The patient's laboratory values are checked every 3 months. The serum creatinine level AANP AGPCNP PSI Test 1 & 2 Questions with Answers 2024 has shown significant increases at each of the two most recent measurements. Which of the following medications could be contributing to the serum creatinine increase? 1. Angiotensin-converting enzyme (ACE) inhibitor 2. Calcium channel blocker 3. Corticosteroid 4. HMG-CoA reductase inhibitor - Correct Answer 1. Angiotensin-converting enzyme (ACE) inhibitor 70. If a nurse practitioner suspects malignant otitis externa, an urgent referral must be made to a(n): 1. audiologist. 2. otolaryngologist. 3. neurologist. 4. vestibular specialist. - Correct Answer 2. otolaryngologist.