AANP Practice Questions and Answers 2024 Verified Answers Latest Update, Exams of Nursing

Download AANP Practice Questions and Answers 2024 Verified Answers Latest Update and more Exams Nursing in PDF only on Docsity! AANP Practice Questions and Answers 2024 Verified Answers Latest Update A 65-year-old woman presents for a follow-up examination after a new patient visit. She has not seen a healthcare provider for several years. She is a smoker and her hypertension is now adequately controlled with medication. Her mother died at age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In addition to starting Therapeutic Lifestyle Changes, the nurse practitioner should start the patient on: 1.bile acid sequestrant. 2. a statin drug. 3. a cholesterol absorption inhibitor. 4. low-dose aspirin. - ANS A statin drug. The most commonly prescribed medication for mild systemic lupus erythematosus (SLE) is: 1. azathioprine (AZA). 2. belimumab (Benlysta). 3. ibuprofen (Advil). 4. cyclophosphamide (Cytoxan). - ANS ibuprofen (Advil) 1 The most common sign of cervical cancer is: 1. postcoital bleeding. 2. strong odor from vaginal discharge. 3. itching in the vaginal area. 4. molluscum contagiosum. - ANS postcoital bleeding The nurse practitioner prescribes amitriptyline (Elavil) for a patient with neuropathic pain secondary to diabetes mellitus. On follow-up, the patient complains of urine retention and dry mouth. The practitioner would: 1. discontinue amitriptyline and begin ibuprofen (Motrin). 2. refer to physical therapy. 3. start methocarbamol (Robaxin). 4. discontinue amitriptyline and begin gabapentin (Neurontin). - ANS discontinue amitriptyline and begin gabapentin (Neurontin) A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and omeprazole (Prilosec). The patient complains of headache, abdominal pain, and gas. These symptoms are most likely: 1. associated with the omeprazole. 2. related to the underlying condition. 2 4. ethambutol for 6 months. - ANS isoniazid (nydrazid) for 9 months Unilateral spontaneous serous or serosanguineous discharge from a single duct of a breast is most often caused by: 1. intraductal papilloma. 2. mucinous breast lesions. 3. Paget's disease. 4. ductal carcinoma in situ. - ANS intraductal papilloma A young child with asthma presents for follow-up evaluation. After numerous changes in medications and doses, the parents report that the child continues to have difficulty with coughing, especially during the night. Which of the following conditions would be the most likely cause of the continued asthma symptoms? 1. Vocal cord dysfunction 2. Cystic fibrosis 3. Gastroesophageal reflux 4. Allergic rhinitis - ANS gastroesophageal reflux A pregnant woman with known HIV infection can reduce the risk of perinatal transmission through zidovudine (Retroviral) therapy. Based on current research, optimal therapy is to start daily dosing: 5 1. post amniocentesis. 2. after 14 weeks of gestation. 3. if premature rupture of membranes occurs. 4. if maternal viral loads are greater than 10,000. - ANS after 14 weeks gestation T-wave inversion with a normal ST segment on a 12-lead EKG may represent: 1. acute coronary ischemia. 2. right ventricular hypertrophy. 3. atrial hypertrophy. 4. hyperkalemia. - ANS acute coronary ischemia The 16-year-old mother of a 2-month-old presents the infant, reporting that the child is very irritable and does not feed well. During physical examination, the child's head drops back and the child exhibits sudden flexing of the extremities. As the flexing stops, the child cries uncontrollably. Funduscopic examination reveals retinal hemorrhages. Which of the following diagnostic tests should be ordered? 1. Skull X-rays 2. MRI 6 3. CT scan 4. Pet scan - ANS CT scan The most important diagnostic factor in evaluating angina pectoris is the patient's: 1. King of Heart's monitor. 2. physical examination. 3. history. 4. echocardiogram. - ANS history There are three reasons for latex allergies. Which of the following does NOT cause the problem? 1. Immediate hypersensitivity 2. Irritant contact of dermatitis 3. Cytotoxic hypersensitivity 4. Immune complex reaction - ANS cytotoxic hypersensitivity A patient on warfarin (Coumadin) therapy for recurrent deep vein thrombosis (DVT) is about to have lumbar spinal fusion surgery. The patient's warfarin is put on hold starting 5 days prior to the surgery and subcutaneous Love ox has been ordered for DVT prophylaxis until the 7 2. weight loss. 3. depression. 4. hypothyroidism. - ANS hemolytic anemia An 86-year-old patient presents with pinguecula, a yellow triangular degenerative tissue thickening of the bulbar conjunctiva. This condition is: 1. cured by eye drops. 2. a genetic process. 3. a malignant growth. 4. a solar-induced lesion - ANS a solar-induced lesion During a well-child examination of an 18-month-old, premature tooth decay and inflamed gums, particularly of the maxillary incisors, are noted. The approach to this problem includes: 1. referring the child to a dentist, assessing for bottle feeding and fluoride in local water. 2. teaching the mother to brush the child's teeth, encouraging vitamin supplements. 3. recommending fluoride mouthwash and toothpaste, suggesting celery sticks for snacks. 10 4. providing fluoride treatment, teaching dental hygiene, and eating foods high in calcium. - ANS referring the child to a dentist, assessing for bottle feeding and fluoride in local water Which of the following is typically observed in the GI system upon stimulation of the parasympathetic nervous system? 1. No overall effect 2. Increased sphincter tone 3. Increased peristalsis 4. Decreased secretions - ANS increased peristalsis Type 2 diabetes mellitus is characterized by which of the following? 1. Decreased production of exogenous glucagon-like peptide 2. Autoimmune beta-cell destruction 3. Relative deficiency of dipeptidyl peptidase-4 4. Decreased reabsorption of sodium-glucose transporters - ANS decreased reabsorption of sodium-glucose transporters In pulmonary function testing, forced vital capacity represents the: 11 1. maximum volume of air that can be forcefully exhaled after maximum inspiration. 2. total volume of air that is exhaled after normal inspiration. 3. total volume of air that the lungs can hold, minus the expiratory reserve volume. 4. volume of air that can be forcefully exhaled in 1 second. - ANS maximum volume of air that can be forcefully exhaled after maximum inspiration An adult male presents as first patient of the day after awaking about 5:00 AM with indigestion and chest pressure. On checking his pulse, he found no change from previous measurements. He states that, while waiting for the nurse practitioner to arrive, he began to feel a little clammy. A 12-lead EKG records the following patterns. On the basis of these EKG readings, the diagnosis is: 1. anterior-septal acute myocardial infarction. 2. lateral acute myocardial infarction. 3. inferior acute myocardial infarction. 4. anterior acute myocardial infarction. - ANS inferior acute myocardial infarction During the past 24 hours, a 62-year-old has experienced abdominal pain that radiates to the back. The patient also reports several episodes of nausea and vomiting, a low-grade temperature, and a history of excessive drinking. Physical examination reveals a distended abdomen. 12 The clinical presentation of placenta previa that develops during the third trimester includes: 1. intermittent dark-red spotting. 2. occult bleeding with abdominal or back pain. 3. sudden onset of painless and profuse bleeding. 4. painless occult bleeding that becomes visible upon onset of labor. - ANS sudden onset of painless and profuse bleeding A 27-year-old male patient, who works as a janitor, presents with a 6- month history of an intermittent rash on his hands. History reveals itching and occasional burning. Examination reveals irregularly- distributed scaly maculopapular erythematous patches extending from the dorsum of the hand several inches up the forearms, and dry palms with no nail involvement. The most likely diagnosis is: 1. contact dermatitis. 2. scabies infestation. 3. psoriasis. 4. eczema. - ANS contact dermatitis Anorexia nervosa occurs most commonly in which of the following? 1. Painters 2. Only children 15 3. High-level athletes 4. Individuals from large families - ANS high level athletes A frail elderly patient presents with constipation. Which of the following normal physiologic changes seen with aging is the most likely cause? 1. Decreased bowel muscle tone 2. Increased bile secretion 3. Increased absorption of calcium 4. Decreased pancreatic secretions - ANS decreased bowel muscle tone A patient reports to your office, having been struck on the right cheek with a baseball bat. On examination, you notice tenderness and swelling over the cheek. The patient is unable to gaze laterally with his left eye, and he complains of double vision when he attempts to do so. This is most likely associated with: 1. retinal hemorrhage. 2. orbital rim fracture. 3. subarachnoid hemorrhage. 4. periorbital cellulitis. - ANS orbital rim fractures A 7-year-old child presents with group A streptococcal infection confirmed by throat culture. Past history includes treatment for positive 16 streptococcal infection with erythromycin (Retyped oral suspension) 3 weeks ago. What is the most appropriate next intervention? 1. Treat with amoxicillin for 10 days. 2. Obtain culture for all household members. 3. Treat with azithromycin (Zithromax) for 10 days. 4. Intramuscular Penicillin. - ANS treat with amoxicillin for 10 days A 16-year-old female adolescent is brought to the nurse practitioner's office by her mother, who is concerned about her daughter's recent weight loss. History reveals that the daughter was consistently in the 50th percentile for weight, but is now in the 10th percentile. The mother states that she is concerned that her daughter is purging herself after meals since she often goes to the restroom after eating and remains there for a long period of time. The daughter denies any self- induced vomiting, starvation or excessive activity. She does state that she jogs five miles a day and is in good condition. In addition to a complete blood count with differential, which of the following laboratory tests will be most helpful for further assessment? 1. Electrolytes, fasting blood sugar 2. Creatine phosphokinase, follicle-stimulating hormone (FSH) 3. Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis 4. Electrolytes, FSH, stool for occult blood - ANS electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis 17 4. Streptococcus pneumoniae and Pseudomonas aeruginosa - ANS strep pneumonia and hemophilic influenza A child is being treated with methylphenidate (Ritalin) for attention- deficit disorder. The following are all side effects of Ritalin EXCEPT: 1. muscle cramps 2. mild irritability. 3. increased heart rate. 4. slight increase in growth velocity. - ANS slight increase in growth velocity A geriatric female presents for her annual examination. She has been on antihypertensive medications for over 20 years, with good control. Laboratory values are within normal ranges. The nurse practitioner is concerned about the patient's cardiac health risks, due her to weight and her waist circumference. According to the AHA guidelines, which of the following goals is expected for this patient? 1. Physical activity for 60 minutes daily, for a minimum of 6 days a week 2. Physical activity for 30 minutes daily, 7 days a week 3. Physical activity for 30 minutes daily, for a minimum of 5 days a week 4. Physical activity for 60 minutes daily, 7 days a week - ANS physical activity for 30 minutes daily, for a minimum of 5 days a week 20 The management of COPD in the elderly is best guided by: 1. spirometry. 2. arterial blood gases. 3. radiologic imaging. 4. symptomatology. - ANS symptomatology A young, athletic adult presents with shoulder pain and inability to raise the arm above the shoulder. The most likely diagnosis is: 1. frozen shoulder syndrome. 2. cervical radiculopathy. 3. rotator cuff tear. 4. polymyositis. - ANS rotator cuff tear A 50-year-old male presents with bruises and abrasions on the left leg and forearm, claiming to have had a number of minor accidents at home and at work. The patient reports general feelings of depression, forgetfulness, and, despite the fact that he is regularly employed, a mounting collection of unpaid and overdue bills. In taking the patient's history, a significant pattern of parental alcohol abuse, stroke, TIA, and MI emerges. During questioning to elicit a more thorough diagnosis, the patient becomes hostile and leaves the clinic without further treatment. The most likely explanation for this behavior is: 21 1. Alzheimer's disease. 2. chronic alcoholism. 3. cancer. 4. carotid artery stenosis. - ANS chronic alcoholism A 28-year-old patient presents with profuse yellow vaginal discharge, odor, and local irritation. She reports completing a 7-day course of oral metronidazole (Flagyl), 500 mg b.i.d. 4 weeks ago. She has had multiple recurrences over the last 18 months. Microscopic examination reveals presence of clue cells. What is the most appropriate treatment intervention? 1. Oral metronidazole (Flagyl), 500 mg b.i.d., plus metronidazole vaginal gel (Metro Gel), for 5 days 2. Treat both patient and partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d., for 7 days 3. Metronidazole vaginal gel (Metro Gel) twice weekly for 4 to 6 months 4. Treat patient with metronidazole vaginal gel (Metro Gel) bid. And partner(s) with tetracycline, 250 mg quid. for 7 days - ANS Treat both patient and partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d., for 7 days An adult female who recently returned from a business trip to Japan presents for a recheck appointment. The only remarkable laboratory result is for thyroid-stimulating hormone (TSH), at 0.3 microunits/mL (normal = 0.4-6 microunits/mL). The patient reports that her neck hurts; 22 The symptoms of benign prostatic hypertrophy are often overlooked because the older male: 1. understands that surgery is the only cure for this condition. 2. considers urinary problems to be a normal part of aging. 3. is fearful of the side effects of additional medication. 4. is concerned that he will no longer be able to obtain an erection. - ANS considers urinary problems to be normal part of aging Upon admission to a nursing home, an 85-year-old patient receives a negative result on the purified protein derivative (PPD) test. To determine TB status in the frail elderly, a second PPD should be performed in: 1. 72 hours. 2. 1 week. 3. 3 months. 4. 6 months. - ANS 1 week Which of the following is NOT used for therapy of an acute attack of gout? 1. Colchicine (Colors) 2. Indomethacin (Indocin) 25 3. Methylprednisolone (Solumedrol) 4. Allopurinol (Zyloprim) - ANS allopurinol (zyloprim) A 26-year-old female presents with abdominal distention, bloating, and intermittent crampy abdominal pain relieved by defecation. She has four to six loose stools a day when stressed. Between bouts of diarrhea, she often has constipation. Physical examination results are normal. The CBC was normal. The most likely diagnosis is: 1. diverticulitis. 2. viral gastroenteritis. 3. inflammatory bowel disease. 4. irritable bowel syndrome - ANS irritable bowel syndrome A mother has just noticed that her 15-month-old, 15-kg child has recently ingested an unknown quantity of iron tablets. The mother has ipecac syrup and activated charcoal on hand. The mother should be advised to: 1. take the child to the primary care provider. 2. give ipecac per recommendation on the bottle label. 3. take the child to the emergency room. 4. give the child 30 g of activated charcoal diluted with water - ANS take child to emergency room 26 A 13-year-old is concerned because she has not yet begun to menstruate. Physical examination indicates that the patient is at Tanner stage IV and is of average height and weight. Which of the following would be the most appropriate response to this patient? 1. "We'll need to refer you to an endocrinologist for a complete workup." 2. "We'll need to do some tests to find out why you are not having periods." 3. "I'll give you some pills that will make your periods start." 4. "Your development is exactly as expected for your age; you'll probably begin to have periods within a year." - ANS "Your development is exactly as expected for your age; you'll probably begin to have periods within a year." The most common bacterial cause of cellulitis in patients with diabetes mellitus is: 1. Pseudomonas aeruginosa. 2. group B beta-hemolytic Streptococcus. 3. Staphylococcus aureus. 4. Staphylococcus saprophyticus. - ANS Staphylococcus aureus 27 Stress makes his condition worse, yet baking soda seems to provide some relief. Findings on examination are normal and the stool for occult blood is negative. The preliminary diagnosis(es) should be: 1. esophagitis. 2. esophageal spasm. 3. helicobacter pylori. 4. gastroesophageal reflux disease. - ANS GERD A late adolescent patient presents with complaints of acute-onset unilateral right eye pain, visual changes, seeing halos around lights, abdominal pain, and intermittent nausea. Physical findings include an erythematous right eye without discharge, a cloudy cornea, and a moderately dilated right pupil that is nonreactive to light. The nurse practitioner should immediately: 1. apply steroid drops to the right eye. 2. apply mydriatic drops to the eye. 3. refer to the emergency department. 4. make an appointment for him to see an ophthalmologist. - ANS refer to emergency department In a 6-year-old child, which of the following is the preferred drug for stage 1 Lyme disease? 30 1. Trimethoprim-sulfamethoxazole (Bactrim) 2. Azithromycin (Zithromax) 3. Doxycycline (Dory) 4. Cefuroxime (Ceftin) - ANS cefuroxime (cetin) An 86-year-old patient is experiencing radiculopathy-associated lower back pain that has not improved over the past 4 weeks. The medical history includes a lumbar discectomy. The best type of imaging study for evaluating this patient would be a/an: 1. MRI. 2. spinal X-ray. 3. myelography. 4. nuclear bone scan. - ANS MRI A 30-month-old with a history of frequent ear infections was seen in September after a symptom-free summer. Examination revealed bilateral bulging eardrums. After two separate courses of antibiotics, fluid is noted in both ears. The parent reports speech difficulties. The most likely diagnosis is: 1. otitis media with effusion. 2. myringitis. 3. recurrent acute otitis. 31 4. Eustachian tube dysfunction. - ANS otitis media with effusion A 19-year-old patient who has used oral contraceptives for 3 years plans to discontinue the pill at the end of her current cycle to become pregnant. Which of the following daily supplements would receive the highest priority? 1. Calcium carbonate 2. Folic acid 3. Ferrous sulfate 4. Multivitamin - ANS folic acid A frail elderly widow presents to the senior clinic with a 3- to 4-day history of confusion that became worse the evening before but currently seems a little better, although her speech is rambling and difficult to follow. During the examination, the patient is anxious and agitated. She is on cardiac medications, an antidepressant, and insulin. The most likely diagnosis is: 1. mild stroke. 2. polypharmacy. 3. electrolyte imbalance. 4. agitated depression. - ANS polypharmacy 32