Download AANP Practice Questions And Answers (update) 2023 and more Exams Nursing in PDF only on Docsity!
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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.
- a statin drug.
- a cholesterol absorption inhibitor.
- low-dose aspirin. - Correct Answer ✅ A statin drug The most commonly prescribed medication for mild systemic lupus erythematosus (SLE) is:
- azathioprine (AZA).
- belimumab (Benlysta).
- ibuprofen (Advil).
- cyclophosphamide (Cytoxan). - Correct Answer ✅ ibuprofen (advil) The most common sign of cervical cancer is:
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- postcoital bleeding.
- strong odor from vaginal discharge.
- itching in the vaginal area.
- molluscum contagiosum. - Correct Answer ✅ 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:
- discontinue amitriptyline and begin ibuprofen (Motrin).
- refer to physical therapy.
- start methocarbamol (Robaxin).
- discontinue amitriptyline and begin gabapentin (Neurontin). - Correct Answer ✅ 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:
- associated with the omeprazole.
- related to the underlying condition.
- the result of the NSAID.
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poor hygiene and bruises on her trunk. The neighbor is concerned that the patient often has no money to buy food, despite income from social security and a coal miner's pension. The nurse practitioner suspects abuse. Which of the following is the nurse practitioner obligated to do next?
- Report the case to the proper authorities.
- Tell the neighbor to check on the woman daily and report back.
- Document the data and report the information to risk management.
- Call the patient's family and inquire about the concerns. - Correct Answer ✅ report the case to proper authorities In most cases, the first manifestation of Alzheimer's disease is:
- impaired judgment.
- decrease in short-term memory.
- disorientation in time and place.
- decrease in long-term memory. - Correct Answer ✅ decrease in short- term memory The optimal treatment for latent tuberculosis is:
- rifampin (Rifadin) for 5 months.
- isoniazid (Nydrazid) for 9 months.
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- pyrazinamide for 6 months.
- ethambutol for 6 months. - Correct Answer ✅ osioniazid (nydrazid) for 9 months Unilateral spontaneous serous or serosanguineous discharge from a single duct of a breast is most often caused by:
- intraductal papilloma.
- mucinous breast lesions.
- Paget's disease.
- ductal carcinoma in situ. - Correct Answer ✅ 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?
- Vocal cord dysfunction
- Cystic fibrosis
- Gastroesophageal reflux
- Allergic rhinitis - Correct Answer ✅ gastroesophageal reflux
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uncontrollably. Funduscopic examination reveals retinal hemorrhages. Which of the following diagnostic tests should be ordered?
- Skull X-rays
- MRI
- CT scan
- Pet scan - Correct Answer ✅ CT scan The most important diagnostic factor in evaluating angina pectoris is the patient's:
- King of Heart's monitor.
- physical examination.
- history.
- echocardiogram. - Correct Answer ✅ history There are three reasons for latex allergies. Which of the following does NOT cause the problem?
- Immediate hypersensitivity
- Irritant contact of dermatitis
- Cytotoxic hypersensitivity
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- Immune complex reaction - Correct Answer ✅ 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 Lovenox has been ordered for DVT prophylaxis until the resumption of the warfarin. The nurse practitioner knows that the patient's postoperative warfarin dose should be restarted based on the:
- value of her morning Prothrombin time.
- loading dose of 10 mg, plus the previous warfarin dose.
- baseline PT and INR values.
- target INR of 2. - Correct Answer ✅ caseline PT and INR values An 87-year-old patient presents with round, pruritic plaques and small vesicles on the lower legs. The most likely diagnosis is:
- allergic contact dermatitis.
- plaque psoriasis.
- cutaneous T-cell lymphoma.
- nummular eczema - Correct Answer ✅ nummular eczema
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- evaluate for hearing loss.
- refer to speech therapy.
- re-evaluate in 3 months.
- check for cerumen impaction. - Correct Answer ✅ evaluate for hearing loss The most common side effect of the oral ribavirin used in the treatment of hepatitis C is:
- hemolytic anemia.
- weight loss.
- depression.
- hypothyroidism. - Correct Answer ✅ hemolytic anemia An 86-year-old patient presents with pinguecula, a yellow triangular degenerative tissue thickening of the bulbar conjunctiva. This condition is:
- cured by eye drops.
- a genetic process.
- a malignant growth.
- a solar-induced lesion - Correct Answer ✅ a solar-induced lesion
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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:
- referring the child to a dentist, assessing for bottle feeding and fluoride in local water.
- teaching the mother to brush the child's teeth, encouraging vitamin supplements.
- recommending fluoride mouthwash and toothpaste, suggesting celery sticks for snacks.
- providing fluoride treatment, teaching dental hygiene, and eating foods high in calcium. - Correct Answer ✅ 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?
- No overall effect
- Increased sphincter tone
- Increased peristalsis
- Decreased secretions - Correct Answer ✅ increased peristalsis
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clammy. A 12-lead EKG records the following patterns. On the basis of these EKG readings, the diagnosis is:
- anterior-septal acute myocardial infarction.
- lateral acute myocardial infarction.
- inferior acute myocardial infarction.
- anterior acute myocardial infarction. - Correct Answer ✅ 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. Laboratory serum values indicate elevated alkaline phosphatase, amylase, and serum lipase. The most likely diagnosis is:
- alcoholic liver disease.
- acute mesenteric ischemia.
- viral hepatitis.
- acute pancreatitis. - Correct Answer ✅ acute pancreatitis An otherwise healthy adult female presents complaining of vaginal burning and itching during urination. She has a social history of two
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sexual partners. She denies fever or vaginal discharge, but has noted a lesion on one labium. The nurse practitioner should order all of the following EXCEPT:
- wet mount and potassium hydroxide.
- dark-field microscopy of fluid from the lesion.
- nucleic acid amplification testing for gonorrhea.
- serology for Haemophilus ducreyi. - Correct Answer ✅ dark-field microscopy of fluid from lesion A 3-year-old female has been diagnosed with bacterial meningitis. She attends preschool daily at a local church day care program. The day before her diagnosis, she ate lunch with her mother at a local restaurant. For which contact(s) would chemoprophylaxis with rifampin be recommended?
- Preschool contacts in the past 7 days
- A friend of the patient's sister who visited after school yesterday
- The checkout employee at the grocery store yesterday
- Diners at the restaurant during lunch the day the patient ate there - Correct Answer ✅ preschool contacts in past 7 days Congenital dysplasia of the hip:
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- painless occult bleeding that becomes visible upon onset of labor. - Correct Answer ✅ 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:
- contact dermatitis.
- scabies infestation.
- psoriasis.
- eczema. - Correct Answer ✅ contact dermatitis Anorexia nervosa occurs most commonly in which of the following?
- Painters
- Only children
- High-level athletes
- Individuals from large families - Correct Answer ✅ 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?
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- Decreased bowel muscle tone
- Increased bile secretion
- Increased absorption of calcium
- Decreased pancreatic secretions - Correct Answer ✅ 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:
- retinal hemorrhage.
- orbital rim fracture.
- subarachnoid hemorrhage.
- periorbital cellulitis. - Correct Answer ✅ orbital rim fractures A 7-year-old child presents with group A streptococcal infection confirmed by throat culture. Past history includes treatment for positive streptococcal infection with erythromycin (EryPed oral suspension) 3 weeks ago. What is the most appropriate next intervention?
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An adult female who is homeless presents for an initial obstetric visit at 34 weeks of pregnancy. She is diagnosed with Chlamydia trachomatis infection. What complication will her newborn be most at risk?
- Conjunctivitis
- Hearing loss
- Pneumonitis
- Meningitis - Correct Answer ✅ conjunctivitis A 2-year-old male presents for reevaluation. Two days ago, he had four episodes of vomiting and six diarrheal stools. On physical examination today, his vital signs reveal P = 120 and capillary refill of 3 seconds. The patient's eyes are sunken and his extremities are mottled and cool to the touch. The treatment plan would include:
- start oral electrolyte mixture every hour.
- hospitalization for IV fluid replacement.
- giving the child loperamide for each diarrheal stool.
- catheterizing the child to obtain accurate urine output. - Correct Answer ✅ hospitalization for IV fluid replacement
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A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d. for angina. The patient is unable to remember to take the medication at the scheduled times. The practitioner should:
- discontinue the issue with the patient's daughter.
- change the dose to extended release 30 mg daily.
- reinforce the importance of taking the medication.
- increase the dosage to 20 mg b.i.d. - Correct Answer ✅ change the dose to extended release 30mg daily A pediatric male is present with his mother, who states that he is extremely restless at night and constantly scratches his anal area. Which diagnostic procedure would confirm a diagnosis of pinworm infestation?
- The patch test
- Examination of bed linens
- Examination of transparent tape sample from perianal skin
- Blood tests for anemia and eosinophilia - Correct Answer ✅ examination of transparent tape sample from perianal skin Which of the following microorganisms are most frequently associated with acute bacterial rhino-sinusitis?
