FNP AANP Practice EXAM 2024 AND PRACTICE QUESTIONS |ACCURATE ANSWERS| VERIFIED, Exams of Nursing

Download FNP AANP Practice EXAM 2024 AND PRACTICE QUESTIONS |ACCURATE ANSWERS| VERIFIED and more Exams Nursing in PDF only on Docsity! FNP AANP Practice EXAM 2024 AND PRACTICE QUESTIONS |ACCURATE ANSWERS| VERIFIED FOR GUARANTEED PASS |GRADED A |NEW VERSION WITH 150+ QUESTIONS A 47-year-old patient presents with complaints of upper abdominal discomfort with nausea and burning after eating. The patient does not currently take any medications. The most likely differential diagnoses would include: - Ans - gastritis and peptic ulcer disease. A patient with a diagnosis of diverticulosis presents with localized left lower quadrant discomfort, a palpable mass, mild leukocytosis, and T = 100°F (37.8°C). The patient does not appear toxic and can tolerate fluids. An appropriate plan should include: - Ans - clear liquids and oral antibiotics. Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion? - Ans - Gentamicin ophthalmic (Genoptic) The most common bacteria responsible for pneumonia in older adults residing in the community is: - Ans - Streptococcus pneumoniae. 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? - Ans - Providing reassurance The parent of a 13-year-old diagnosed with seizure disorder calls to report that the child is exhibiting symptoms of a cold, but has no fever. The nurse practitioner should advise the parent that the development of fever may: - Ans - lower the seizure threshold. A common rule to follow when prescribing many medications for the elderly is to: - Ans - start at a lower dose than what is commonly prescribed for adults, and increase the dose slowly. Which class of antihypertensive agents has been associated with acute renal failure and is contraindicated in patients with bilateral renal artery stenosis? - Ans - Angiotensin-converting enzyme (ACE) inhibitors After a 3-week camping trip, an 11-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: - Ans - doxycycline (Doryx). An 18-month-old child presents with a bulging, immobile tympanic membrane; T = 103°F (39.4°C). Assessment also reveals a grade II/VI systolic murmur at the left sternal border. After initiation of treatment for otitis media, the most appropriate intervention is to: - Ans - reevaluate the patient in 10 days. Research findings have shown that, in order to improve the longevity of a patient who has COPD, the treatment of choice is: - Ans - oxygen. The management of choice for polymyalgia rheumatica includes: - Ans - prednisone. A 40-year-old male presents with a 2-week history of rectal pain and itching. He reports a past history of constipation and finding spots of bright red blood on toilet paper several times a week. Rectal examination reveals a tender, swollen, bluish, ovoid mass. The stool guaiac test is negative. Which of the following actions should the nurse practitioner take? - Ans - Prescribe bulk-forming agents and hydrocortisone suppositories. A 2-year-old child is diagnosed with radial head subluxation ("nursemaid's elbow"). After closed manipulation, the best indication of successful treatment is that: - Ans - the child quickly begins to use the affected arm. Which of the following is the most serious outcome of Barrett's esophagus? - Ans - Esophageal adenocarcinoma The follow-up examination of a 12-month-old treated 2 weeks ago for bilateral otitis media reveals a normal left tympanic membrane and a right tympanic membrane with visible serous fluid levels and decreased mobility. An appropriate plan should include a: - Ans - follow-up evaluation of the ears in 2 months. A 68-year-old female presents with a new onset of left-sided throbbing headache. She has noticed some spots in her visual fields that come and go. She is being treated with an NSAID for arthritis. Sedimentation rate is elevated, but all other laboratory values are within normal limits. The headache is most likely due to: - Ans - Your answer: temporal arteritis. 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. The patient now presents to a nurse practitioner's office with a fever of 101.2°F (39.4°C) and a cough productive of thick, yellow-green, foul-smelling sputum. The nurse practitioner should encourage smoking cessation and prescribe: - Ans - Your answer: a macrolide antibiotic. Which of the following laboratory tests are most widely accepted as indicators of the progression of HIV infection? - Ans - CD4 count and viral load A patient who is 28 weeks pregnant reports a single episode of vaginal bleeding. History indicates normal prenatal progress to date, and the patient denies pain, vaginal itching, or discharge. Which of the following is the most appropriate intervention to aid in the diagnosis of this case? - Ans - Ultrasound A 3-year-old patient presents at an inner-city clinic with fever, cough, malaise, and loss of appetite. The patient lives with several relatives, including a grandmother who also has a cough. Which of the following diagnostic tests would be most appropriate for the patient? - Ans - Sputum culture Which of the following best describes psoriatic lesions in an elderly patient? - Ans - Red, sharply defined plaques with silvery scales A patient is referred with a diagnosis of diabetes mellitus, hypertension, and coronary artery disease. The patient is on both insulin and a beta blocker. Assuming that the patient will continue the beta blocker, it will be important to educate the patient on the recognition of hypoglycemia. Which symptom would be most indicative of hypoglycemia in this patient? - Ans - Sweating An 88-year-old male presents with concerns about memory loss. He feels good, takes an aspirin daily, and has no chronic diseases. He lives alone, drives his own car, and manages his financial affairs. To evaluate his memory, which of the following tests should the nurse practitioner choose? - Ans - Folstein Mini-Mental State Examination Which of the following is the leading cause of cancer-related deaths in the majority of women? - Ans - Lung cancer Which of the following findings is typically a sign of acute appendicitis? - Ans - Rebound tenderness at McBurney's point A patient with macular degeneration has difficulty seeing objects: - Ans - In the center of the visual field. To assess a patient's ability to think abstractly, a nurse practitioner could ask the patient: - Ans - the meaning of a common proverb. During an employment physical examination of a 21-year-old female, bruising around the areolae on the breasts is noted. An appropriate health history for these findings should include all of the following EXCEPT: - Ans - socioeconomic status. The best laboratory test to distinguish iron deficiency anemia from other anemias is: - Ans - serum ferritin level. A 17-year-old female is suspected of having polycystic ovary syndrome. In addition to testosterone, the most appropriate diagnostic tests to order would be: - Ans - follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (TSH). Office spirometry performed with an albuterol nebulizer treatment can confirm a diagnosis of asthma because it indicates: - Ans - whether a patient has reversible airway obstruction. An 88-year-old patient presents with right-sided weakness after being unable to rise unassisted following a fall to the bathroom floor. History includes aphasia and noncompliance with a hypertension medication regimen. What is the most likely diagnosis? - Ans - Left-sided stroke 29-year-old male with noncomplicated Chlamydia infection may exhibit: - Ans - no remarkable clinical symptoms. To assess spinal function at the S1 level, which deep tendon reflex should be tested? - Ans - Achilles An 18-year-old college student presents for an athletic physical. When asked about current medications, she mentions that she takes "some herb" she bought at a health food store for migraines and menstrual cramps. Which of the following herbal remedies has been commonly used for these conditions? - Ans - Feverfew An 88-year-old patient has had a gradual onset of hearing loss in the left ear. Examination shows a large accumulation of cerumen in the external auditory canal. Assuming there is no neural loss, the nurse practitioner would expect the Weber test to: - Ans - lateralize to the left. Trigeminal neuralgia manifests itself primarily with: - Ans - electric-shock-like unilateral facial pain. A 65-year-old male presents to a clinic complaining of increasing fatigue, dyspnea on exertion, and ankle edema during the day. He has a history of mild hypertension, for which he saw his physician years ago. The physician advised the patient to decrease his salt intake. On physical examination, the patient is tachycardic, positive for jugular venous distention, and positive for S3, with a systolic murmur. Chest X-ray reveals cardiomegaly with vascular redistribution. The nurse practitioner's diagnosis should be: - Ans - heart failure. Which of the following criteria differentiates a TIA from a stroke? - Ans - Absence of residual symptoms 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: - Ans - HIV infection. A 14-year-old patient who fell on an outstretched hand complains of proximal forearm pain. X-ray reveals a positive fat pad sign, and the patient is unable to fully extend the elbow. No definitive bony changes are seen on X-ray. The most likely working diagnosis is: - Ans - radial head fracture. A 2-month-old infant is presented for examination and immunizations. History includes an uncomplicated full-term delivery and hepatitis B virus immunization shortly after birth. Examination is unremarkable except for a diffusely erythematous (non-beet-red) macular rash in the diaper area, sparing the inguinal folds. No satellite lesions are noted. The infant's diaper rash is most likely caused by: - Ans - contact dermatitis. A 17-year-old female has never had her menses. She is at Tanner stage III of sexual development. Her physical examination is completely normal, and her weight is appropriate for her age and height. What is the most likely diagnosis? - Ans - Primary amenorrhea A 70-year-old male presents with paresthesia of the lower extremities. On examination, the patient appears pale and shows a decreased vibratory sense. Laboratory tests reveal elevated indirect bilirubin; Hct = 30%; mean corpuscular volume (MCV) = 120 µm3 [normal = 87-103 µm3]. The most likely diagnosis is: - Ans - pernicious anemia. Hegar's sign - Ans - Softening of lower uterine segment Chadwick's sign - Ans - Bluish color of cervix and vagina at 6-8 weeks Goodell's sign - Ans - Softening of cervix at 4+ weeks Lipids in chronic inactivity - Ans - Low HDL Lipids in under- or untreated hypothyroidism - Ans - Elevated total cholesterol, TG, and LDL Lipids in chronic renal insufficiency - Ans - Elevated total cholesterol and TG Lipids in alcohol abuse - Ans - Elevated TG, HDL, and LDL Vaccines with live attenuated viruses - Ans - MMR, varicella, flu-mist(intranasal), Zostavax Drugs of choice for abdominal infection - Ans - Beta lactams + metronidazole (most common); fluoroquinolones Drugs of choice for urinary tract infection - Ans - Fluoroquinolones (except moxi), TMP-SMX, fluconazole, b-lactams, nitrofurantoin, fosfomycin if pt has many allergies Drugs of choice for pulmonary infections - Ans - Macrolides, resp fluoroquinolones, b-lactams, doxycycline (MRSA, atypical coverage) Drugs of choice for skin and soft tissue infections - Ans - MRSA: TMP-SMZ, doxycycline, clindamycin; b- lactams Drugs of choice for MRSA - Ans - Vancomycin, daptomycin , linezolid, TMP-SMZ, doxycycline, ceftaroline Macrolide drugs - Ans - Erythromycin, clarithromycin, azithromycin Macrolide AEs - Ans - GI, QT prolongation Tetracycline uses - Ans - MRSA, rocky mtn spotted fever, atypicals (mycoplasma pneumonia, chlamydia), spirochetes (Lyme), h.pylori Tetracycline AEs - Ans - GI, teeth, hepatic dysfunction, photosensitivity Fluoroquinolone drugs - Ans - Ciprofloxacin, levofloxacin, moxifloxacin Fluoroquinolone uses - Ans - UTI (cipro or levo), atypicals (mycoplasma, legionella) Fluoroquinolones and dairy or vitamins - Ans - Take 2 hrs before or 4 hours after (decrease concentrations) Metronidazole (Flagyl) uses - Ans - C. Diff, vaginitis Metronidazole AEs - Ans - GI, peripheral neuropathy, disulfiram reaction Nitrofurantoin uses - Ans - UTI -not pyelonephritis due to no systemic absorption Nitrofurantoin AEs, contraindications - Ans - Pulmonary fibrosis, contraindicated in CrCl <60 (excludes many elderly) Aminoglycoside drugs - Ans - Gentamycin, tobramycin Aminoglycoside uses - Ans - Atypical coverage, resistant infections, tobramycin for CF only Myocardial injury EKG changes, - Ans - ST segment elevation, tall peaked t wave Myocardial infarction EKG changes - Ans - Q wave 1st gen antihistamines - Ans - Diphenhydramine, chlorpheniramine 2nd gen antihistamines - Ans - Loratadine, desloratadine, cetirizine, fexofenadine, levocetirazine Ishihara chart - Ans - Test for color blindness Scarlet fever presentation - Ans - Sandpaper-like rash, exudative pharyngitis, localized anterior cervical lymphadenopathy, rash 2 days after pharyngitis then peels later Roseola (HHV-6) presentation - Ans - Rash lasts hours to 3 days, follows 3-7 day high fever, sometimes febrile seizures, tx supportive Rubella (German measles, rubella virus) - Ans - Mild sx, posterior and postauricular cervical lymphadenopathy, arthralgia 5-10 days before rash, teratogenic, contagious 1 week before and 2 weeks after rash Measles (rubeola) - Ans - Acute presentation, generalized lymphadenopathy, photophobia, koplik spots, pharyngitis mild w/o exudate, rash 3-4 days after sx, contagious 1 wk before and 2-3 weeks after rash, permanent neuro impairment and/or death possible, tx supportive Hand foot mouth dz (coxsackievirus a16) - Ans - Fever, malaise, sore mouth, anorexia, lesions, fecal- oral or droplet, highly contagious 2-6 wks, tx supportive Fifth disease (human parvovirus b19) - Ans - Rash starts on face (slapped cheek) spreads to trunk, extremities, contagious before rash but not during or after. Droplet. Leukopenia. Hydrops fetalis in pregnant. Tx supportive. Infectious mononucleosis (Epstein-Barr) - Ans - Diffuse lymphadenopathy, hepatic and splenic tenderness/ enlargement, incubation 20-50 days, systemic corticosteroids if resp distress from swollen airway, monospot/leukopenia w/ atypical lymphocytes diagnostic. Avoid contact sports at least one month. Kawasaki disease - Ans - Acute phase: fever >= 104 >= 5 days, polymorphous exanthem on trunk/flexor region/perineum, erythema of oral cavity (strawberry tongue), chapped lips, bilateral conjunctivitis w/o discharge, edema/erythema of hands and feet w peeling skin. Children 1-8yr. Tx IV immunoglobulin, pop aspirin, consult Lyme stage 1 (early localized disease) - Ans - Mild flu-like illness, singular annular lesion (erythema migrans), sx resolve 3-4 wks w/o tx Lyme stage 2 (early disseminated) - Ans - Months after initial infx, classic rash may reappear w/ multiple lesions. Arthralgias, myalgia, HA, fatigue. Less common: heart block, neuro findings (Bell's palsy) Lyme stage 3 (late persistent) - Ans - 1 year after initial infection, msk s/s persist w/ joint pain, frank arthritis, joint damage. Neuropsychiatric findings - memory problems, depression, neuropathy. Lyme organism - Ans - B. burgdorferri (tick-transmitted spirochete) Lyme testing - Ans - ELISA confirmed with western blot Lyme tx - Ans - Doxycycline (children >8yo), amoxicillin, cefuroxime - adults and children Chancroid tx - Ans - Azithromycin or ceftriaxone, alt. ciprofloxacin or erythromycin Genital herpes (HSV 2) tx - Ans - Acyclovir Lymphogranuloma vereneum (c. trachomatis) tx - Ans - Doxycycline, or erythromycin Nongonococcal urethritis/cervicitis (c. Trachomatis) tx - Ans - Azithromycin or doxycycline Gonococcal urethritis/cervicitis tx - Ans - Cefixime or ceftriaxone, add azithromycin or doxy if chlamydia not ruled out Bacterial vaginosis tx - Ans - Metronidazole Pelvic inflammatory disease tx - Ans - Ceftriaxone+doxycycline +/- metronidazole Trichomoniasis tx - Ans – Metronidazole Cranial nerves responsible for extraoculomotor movements? - Ans - a. 2, 3, 6? b. 3, 4, 6? Patient with hx of hypertension and stroke, now having memory loss and confusion - indicates what? - Ans - a. Alzheimer's b. Vascular Dementia? CAGE acronym - Ans - ? Treatment for chronic alcoholism? - Ans - ? Frail elderly mammogram breast tissue? - Ans - ? Patient has Barrett's esophagus, insurance no longer covers gastroenterologist who was treating condition, patient at the FNP office, wanting a prescription for medication... What should the FNP do? - Ans - a. Refer to oncologist? b. Refill prescription? GERD treatment? - Ans - a. PPI? Per American College of Gastroenterology, treatment should begin with a PPI. b. Routine followup? Osgood Schlatter Disease pain location? - Ans - Growth plate fracture (Salter-Harris fx) location and pain? - Ans - Rotator Cuff injury presentation? - Ans - Causes of tachycardia? - Ans - a. Fever? b. Anemia? c. Hypotension? Definitive diagnosis of acute bacterial proctatitis? - Ans - a. Urinalysis and Culture b. Vigorous Massage of Prostate to Release Fluid for Culture? c. Urethral Culture? Man with high BPH, perform digital rectal exam - how does prostate feel? - Ans - a. Asymmetrical, Nodular, Firm b. Symmetrical, Boggy ? Patient present with "bag of worms", what does this indicate? - Ans - a. Varicocele Legg-Calve-Perthes disease? - Ans - Avascular necrosis of the proximal femoral head... McMurray's Sign - Ans - Epitaxis is most common in the area of the nose known as Kiesselbach's Triangle, where is this located? - Ans - a. anterior septum? b. middle turbinate? c. sinus turbinate? Elderly presents with atrophic vaginitis, small uterus, and palpable 4x5 ovary, what do you do? - Ans - a. Pelvic ultrasound? Grade 3 cells on Pap, treatment? - Ans - ? Patient with bleeding after menopause? - Ans - a. Endometrial biopsy? Young adult female, wants birth control, forgets to take pills, doesn't want to get pregnant for at least 5 years, what do you suggest? - Ans - a. Intrauterine Device? Shingles near eye, patient wants cream and analgesic, what do you do? - Ans - a. Order Acyclovir cream and analgesic? b. Immediate referral to opthamologist? Patient presents with rash on shoulder, erythematous maculopapular rash with center clearing, and scaling? - Ans - a. Tinea Pedis? b. Tinea Corporis? c. Psoriasis? Peripheral vision loss = ? Central vision loss = ? - Ans - Patient with Atopic Dermatitis, look for what other diseases? - Ans - a. Asthma? Patient forgot to start Thanksgiving dinner, and husband states that she has trouble remembering tasks and has trouble with organization... What is this indicative of? - Ans - a. Alzheimer's? b. Delerium? Quick assessment of patients fall risk? - Ans - a. Timed Get up and Go? Mitral Regurgitation = sound and heard best at? Mitral Stenosis = " " " " " "? Mitral Prolapse = " " " " " "? Mitral Sclerosis = " " " " " "? Aortic Stenois = " " " " " "? Aortic Regurgitation = " " " " " "? Aortic Sclerosis = " " " " " "? - Ans - 3 ways to assess cognitive function in patient with signs/symptoms of memory loss - all but which of the following? - Ans - a. Mini Mental b. Depression Screen c. d. Patient voices aching when ambulating? *This question did not specify if it was bilateral or unilateral* *Mentioned something about "rubor" but I can't remember what it said exactly...* - Ans - a. DVT? b. Venous Insufficiency? c. Arterial Insufficiency? Patient with HIV took high-potency anti-viral treatments and CD4 is >400, what does this indicate? - Ans - a. Patient has full-blown AIDS as defined by the CDC? ? Patient has following labs: listed serology for Hepatitis, and then had to know if they had an active infection or immune, etc... - Ans -