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AANP AGPCNP COMPLETE
EXAM QUESTIONS WITH 100%
CORRECT ANSWERS LATEST
UPDATE (2024)-
An 88-year-old presents with right-side weakness after being unable to rise unassisted following a fall tothe 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 Which of the following signs/symptoms are often associated with headaches due to intracranial tumor?
- pain worse laying down, focal neurological signs
- Hyperflexia, personality change
- acute onset: hours to days
- pupillary constriction; stupor Which of the following pharmacotherapeutics would be most important to administer to a patient who hasa corneal abrasion?
- Timolol
- Gentamicin ophthalmic
- Cromolyn optha
- Olopatadine
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
- elevated TSH
- Thyroid enlargement
- atrial fibrillation
- abnormal T3 suppression A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly irregular R-Rinterval. This arrhythmia is:
- atrial flutter
- atrial fibrillation
- second degree heart block
- Wolff-White Syndrome In a healthy elder, which of the following TRADITIONALLY defines a positive urine culture?
- ≥100,000 colonies/mL of a single organism
- ≥10,000 colonies/mL of a single organism
- ≥100,000 colonies/mL of a two or more organisms Which of the following physical findings would best alert a nurse practitioner to the probability of aherniated lumbar disc?
- Positive Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 90°
- Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30°
- Negative Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 80° A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouththat do not rub off when wiped with a 4 × 4. The patient should be evaluated for:
A 16-year-old female in the first month of taking Ortho-Novum 7/7/ complains of mid cycle spotting.She has not missed any doses and uses no other medication. Which of the following is appropriate?
- Changing to Ortho-Novum 1/
- Discontinue use
- Providing reassurance
- Double dose-for two days A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. Onphysical examination, her lungs are clear bilaterally. There are a mid systolic click and a grade II/VI systolic murmur at the apex. Further evaluation would include which of the following?
- EKG, flat plate of the abdomen, lipid profile
- Echo cardiogram, Doppler, EKG
- Labs and benzo's
- EEG, Anxiety Scale, and electrolytes A patient with diabetes mellitus who is on NPH and regular insulin split-dosing presents with complaintsof early morning rise in finger stick 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 mostlikely an example of:
- insulin resistance
- the Somogyi effect.
- needing more insulin in the mornings
- Need to increase insulin at night A manifestation of autonomic neuropathy in a 70-year-old patient with diabetes mellitus is:
- tremors.
- orthostatic hypo tension.
- hypertension
- color blindness The management of COPD in the elderly is best guided by:
- pulse oximetry
- arterial blood gases
- radio graphic images
- symptomology
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 micro albumin is 60 mg/L (normal < 30 mg/L). In additionto changing the diabetes medications, the nurse practitioner would also ensure that the patient is taking:
- nifedipine 12.5mg daily
- Amlodipine 10mg daily
- benazepril, 10 mg daily.
- atenolol 25mg BID In geriatric patients, the polyvalent pneumococcal vaccine:
- prevents or lessens the severity of 60%-70% of pneumococcal infections.
- has no affect on immuno compromised patients
- prevents pneumonia 100% of the time 87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The best actionis to:
- initiate passive warming
- apply a re-breather
- Perform fluid replacement
- initiate active warming According to the American Diabetes Association, the newest standard for determining the presence ofdiabetes mellitus based on fasting plasma sugar level is a value equal to or greater than:
- 110 mg/dL.
- 126 mg/dL.
- 135
- whatever What type of exercise would you recommend for a 74-year-old patient with hypertension anddegenerative joint disease (DJD)?
- Stationary bike
- Aqua exercises
- aerobic walking A 65-year-old patient with hypertension and associated angina requests a flu vaccine. The patient had apneumococcal vaccine 10 years ago. The most appropriate plan of care would include:
- influenza vaccine, 0.5 mL IM,
- Celexa
- Prozac
- Paxil
- Zoloft
- Fluoxetine (Prozac) Trigeminal neuralgia
- electric shock like unilateral pain
- jaw pain extending to the neck
- Bilateral burning pain In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves:
- decreased cardiac output.
- loss of vascular tissue elasticity.
- hyperactive baroreceptors When initiating thyroid hormone replacement in the older adult, care must be taken to evaluate thepatient's:
- coronary status.
- weight
- renal function
- mental state Age-related macular degeneration leads to which of the following?
- Loss of central vision
- Loss of peripheral vision
- hemianopsia bilateral Which class of anti hypertensive agents has been associated with acute renal failure, and is absolutelyCONTRAINDICATED in patients with bilateral renal artery stenosis?
- Thiazide diuretics
- Angiotensin-converting enzyme (ACE) inhibitors
- Calcium channel blockers
- Potassium sparing diuretics
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, thenurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris. Theband is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
- corneal abrasion
- arcus senilis
- corneal ulcer
- herpetic infection of the eye Office spirometry performed with an albuterol nebulizer treatment can confirm a diagnosis of asthmabecause it indicates:
- a patient has pulmonary fibrosis
- chronic carbon dioxide re-tension
- if a patient has reversible airway obstruction. Which cranial nerves test the oculomotor eye movement and strabismus?
- CN I III, IV
- CV III, IV and VI
- CN III, V, VII Which of the following is considered the most important factor in understanding and predicting anindividual's health across the life span?
- Psychological profile
- Body habitus
- Family history
- diet history 29 y/o has uncomplicated Chlamydia infection will exhibit:
- green penile discharge
- uticartia
- unremarkable symtpoms
- penile ulcer 37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
- spirometry
- MRI
- COntract venogra[hy
- helical CT pulmonary angiograph
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:
- change to clopidogrel (Plavix).
- change to valproic acid
- refer for endoarectomy
- change to bulibital A 57-year-old patient presents for a physical examination. The patient has been in good health, takes nomedications, 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?
- TD
- Influenza
- PNA
- Hep B To assess ability to reason abstractly, you would ask the patient to:
- the meaning of a common proverb
- ask what they would do if there was a fire in the house
- count backwards by 7's 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:
- xray
- pulmonary function test
- bronchoscopy
- H & H
- xray (tb-night sweats) 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 inter digital webs of the hands. The most likelydiagnosis is:
- xerosis
- herpes zoster
- eczema
- scabies. The approved therapeutic International Normalized Ratio (INR) for a patient on warfarin (Coumadin)therapy for atrial fibrillation is:
- 1.0-2.
- 2.0-3.
- 2.5-3. Which of the following would be most appropriate to perform in the initial evaluation of a patient withsymptoms of acute prostatitis?
- Prostate-specific antigen (PSA)
- Urinalysis and urine culture
- Scrotal massage and urine sample
- CBC with diff A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would youeducate this patient on recognizing the signs and symptoms of hypoglycemia?
- Edema
- Tachycardia
- palpitations
- sweating 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 smokinghabit 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:
- a penicillin antibiotic
- a macrolide antibiotic.
- vestibular neuritis.
- vertibailar insufficiency
- TIA A healthy 84 y/o would like to start an exercise program, what would you do before this takes place?
- physical exam
- EKG
- knee xrays
- PT Stress test
- Physical Exam An 85-year-old male relates that on the way to his annual physical examination, he suffered a sudden lossof 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:
- opthalmolic migraine
- retinal detachment.
- diabetic retinopathy.
- TIA Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis?
- Organisms about the size of white blood cells with undulating flagellum, occasional lactobacillus,many white blood cells
- Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, manywhite blood cells
- Squamous epithelial cells with stippling appearance and indistinct borders, many lactobacillus rods,few white blood cells A 32-year-old patient reports a 6-month history of intermittent symmetrical swelling of the wrists anddaily morning stiffness lasting 1 hour or more in and around other joints. What is the most likely diagnosis?
- Rheumatoid arthritis
- Osteoarthritis
- Gouty 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?
- Echinacea
- St. JOhn's Wort
- ginko biloba
- Feverfew The most common bacterial agents responsible for pneumonia in older adults residing in the communityare:
- Streptococcus pneumoniae and Haemophilus influenzae.
- staphylococcus aureas and Haemophilus influenzae.
- Psuedomonas aeruginosa and Klebsiella pneumonae
- Legionnaires and streptococcus pneumoniae
An 18-year-old patient presents with complaints of maxillary facial pain
and yellow nasal discharge for14 days. What is the appropriate initial pharmacologic intervention?
- Amoxicillin
- Diphenhydramine
- Doxycycline
- erythromycin Therapy for temporal arteritis would include:
- Tylenol with codiene
- ibuprofen 800mg TID
- prednisone, 60 mg daily PO and re-evaluate in 1 month. According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT acurrent recommendation guideline for preventive care in elderly female patients?
- Mammogram and clinical breast exams
- Fecal Occult blood test and/or sig
- Rubella serology or vaccination history
- Pnuemo and influenza vaccines A 70-year-old farmer was hit in the eye with a tree branch. The first step in the assessment of a possiblecorneal abrasion is to:
- starting H2 blockers.
- taking off from work until the work-up is complete.
- Reporting nausea/vomiting
- Discontinue NSAIDS An 87-year-old obese female presents with complaints of calf pain in her right leg. The patient reportsthat 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:
- calf circumference and perform Doppler studies.
- popliteal pulses and Doppler studies
- Femoral pulses and skin temperature
- Patrick's signs and popliteal pulses 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:
- BUN and serum creatinine.
- 24 hour urine
- parathyroid hormone level.
- thyroid panel After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing, located in theinguinal area. The patient has had a severe headache, malaise, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes:
- Bactrim
- azithromycin
- doxycycline (Doryx).
- metronidazole
- doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with WEstern Blot) 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:
- send to ophthalmologists
- florescreen staining
- test visual field
- prescribe eyedrops 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 hoursprior 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?
- Xray of shoulder
- Palpate structures around the shoulder.
- MRI of shoulder
- EMG
