AANP CLINICAL SCENARIOS ACTUAL EXAM
2026 CERTIFICATION PREPARATION
WORKBOOK EVIDENCE BASED PRACTICE
MODULE COMPLETE SOLUTIONS
◉ heart murmur with holosystolic or pan systolic
Heart mumur with mid systolic Answer: MR - radiate axilla, 5th ICS
MCL, apex,
AS - radiate neck, 2ICS right sternal border
MR ASSH
◉ Coarctation of Aorta Answer: COA: bounding radial and weak
femoral pulse
increase blood pressure in arms, and lower pressure in lower legs.
-congenital cardiac condition characterized by a narrowing of the
aorta
-
◉ Murmur Grade III - VI Answer: Loud murmur easily heard
,◉ JVD caused by Answer: -tension pneumothorax,
-Rt. sided heart failure,
-cardiac tamponade,
-traumatic axphysia from
Increase in portal pressure(LIVER) in venous side or cor pulmonale
◉ pt. with gradual onset of fever, hemorrhages on nail beds, painful
raised red nodules, rash on palms Answer: endocarditis , painful red
spots on fingers olser's nodes, janeway legions rash on palms and
soles.
◉ Know the difference between Peripheral Arterial Disease and
Chronic Venous Insufficiency or PVD. There was question about PAD.
Answer: PAD: Absence of pulse, decrease blow flowing down, PAIN,
Dx doppler or ABI<0.9, TX exercise by walking or antiplatelet,
PVD: Volume, edema, discoloration, decrease blood going up,
◉ Chronic Bronchitis Treatment Answer: Smoking cessation
Pulmonary rehabilitation
Pharmacologic therapy
,Supplemental oxygen
◉ TB... PPD is positive if area of induration is: Answer: >5 mm in an
immunocompromised patient or close contact
>10 mm in immigrant, health care workers, drug user
>15 mm in a patient who lives in an area where TB is very rare.
◉ what condition would make you order Lateral X-ray of the neck.
Options include: Drooling, Unable to do ROM of the neck / stiff neck.
Answer: Croup/Epiglottitis
◉ AV nicking (Arterioles pressing on vein of the eye) Answer: HTN
retinopathy
◉ intraocular pressure (IOP) Answer: Fluid pressure inside the eye;
measured with tonometry
◉ Rovsing sign Answer: pain in the RLQ when the LLQ is palpated
(indicative of appendicitis)
◉ Pencil-like stools occur in an obstruction of what Answer: Sigmoid
descending colon
It's a thin narrow stool and possible causes include colon cancer,
diarrhea, IBS. Refer for GI colonoscopy
, ◉ headache after trauma Answer: SDH
◉ migraine headache Answer: -paroxysmal (sudden, periodic)
attacks of mostly unilateral headache, often accompanied by
disordered vision, nausea, or vomiting, lasting hours or days and
caused by dilation of arteries.
4-12 hours,
abortive triptans
prophylaxis propranolol, TCA amitriptyline, anticonvulsants
topiramate
◉ Vitamin B12 Answer: Folate shares a close relationship with this
other B Vitamin.
◉ Vitamin B12 Answer: Cognitive deficits, glossitis, pernicious
anemia,
Folate shares a close relationship with this other B Vitamin.
◉ 88/yr. old patient in for follow up secondary. She's been treated
with Tylenol for Joint arthritis. Her SED rate was checked after 6
2026 CERTIFICATION PREPARATION
WORKBOOK EVIDENCE BASED PRACTICE
MODULE COMPLETE SOLUTIONS
◉ heart murmur with holosystolic or pan systolic
Heart mumur with mid systolic Answer: MR - radiate axilla, 5th ICS
MCL, apex,
AS - radiate neck, 2ICS right sternal border
MR ASSH
◉ Coarctation of Aorta Answer: COA: bounding radial and weak
femoral pulse
increase blood pressure in arms, and lower pressure in lower legs.
-congenital cardiac condition characterized by a narrowing of the
aorta
-
◉ Murmur Grade III - VI Answer: Loud murmur easily heard
,◉ JVD caused by Answer: -tension pneumothorax,
-Rt. sided heart failure,
-cardiac tamponade,
-traumatic axphysia from
Increase in portal pressure(LIVER) in venous side or cor pulmonale
◉ pt. with gradual onset of fever, hemorrhages on nail beds, painful
raised red nodules, rash on palms Answer: endocarditis , painful red
spots on fingers olser's nodes, janeway legions rash on palms and
soles.
◉ Know the difference between Peripheral Arterial Disease and
Chronic Venous Insufficiency or PVD. There was question about PAD.
Answer: PAD: Absence of pulse, decrease blow flowing down, PAIN,
Dx doppler or ABI<0.9, TX exercise by walking or antiplatelet,
PVD: Volume, edema, discoloration, decrease blood going up,
◉ Chronic Bronchitis Treatment Answer: Smoking cessation
Pulmonary rehabilitation
Pharmacologic therapy
,Supplemental oxygen
◉ TB... PPD is positive if area of induration is: Answer: >5 mm in an
immunocompromised patient or close contact
>10 mm in immigrant, health care workers, drug user
>15 mm in a patient who lives in an area where TB is very rare.
◉ what condition would make you order Lateral X-ray of the neck.
Options include: Drooling, Unable to do ROM of the neck / stiff neck.
Answer: Croup/Epiglottitis
◉ AV nicking (Arterioles pressing on vein of the eye) Answer: HTN
retinopathy
◉ intraocular pressure (IOP) Answer: Fluid pressure inside the eye;
measured with tonometry
◉ Rovsing sign Answer: pain in the RLQ when the LLQ is palpated
(indicative of appendicitis)
◉ Pencil-like stools occur in an obstruction of what Answer: Sigmoid
descending colon
It's a thin narrow stool and possible causes include colon cancer,
diarrhea, IBS. Refer for GI colonoscopy
, ◉ headache after trauma Answer: SDH
◉ migraine headache Answer: -paroxysmal (sudden, periodic)
attacks of mostly unilateral headache, often accompanied by
disordered vision, nausea, or vomiting, lasting hours or days and
caused by dilation of arteries.
4-12 hours,
abortive triptans
prophylaxis propranolol, TCA amitriptyline, anticonvulsants
topiramate
◉ Vitamin B12 Answer: Folate shares a close relationship with this
other B Vitamin.
◉ Vitamin B12 Answer: Cognitive deficits, glossitis, pernicious
anemia,
Folate shares a close relationship with this other B Vitamin.
◉ 88/yr. old patient in for follow up secondary. She's been treated
with Tylenol for Joint arthritis. Her SED rate was checked after 6
