AANP ADULT GERONTOLOGY PRIMARY CARE
NURSE PRACTIOTIONER STUDY GUIDE 2026
WITH COMPLETE SOLUTION
Pheochromocytoma - correct answer-
small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine
, leading to attacks of raised blood pressure, palpitations, and headache. Tx with Alpha blockers
Rovsing's Sign - correct answer-Palpation in LLQ ilicits pain in RLQ indicates appendicitis
NYHA classes of Heart Failure - correct answer-
I No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dy
spnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, pa
lpitation, dyspnea (shortness of breath).
III Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, p
alpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any ph
ysical activity is undertaken, discomfort increases.
Step-wise Approach to Asthma Diagnosis & Treatment - correct answer-Step 1-
Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2 days/week. Albuterol as needed.
Step 2-
Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms > 2 days/week. Albuterol as needed. Lo
w dose ICS ex Flovent. Alt cromolyn, montelukast, nedocromil, theophylline.
Step 3- Mod presistent (FEV1 or PEF 60-
80% predicted. Daily Symptoms. SABA plus low dose ICS or med dose ICS or low dose with leukotriene i
nhibitor (singulair, theophylline, zileuton).
Step 4-
Severe presistent asthma (FEV1/PEF <60% predicted. Symptoms most of day. High dose ICS plus long ac
ting B2 agonist plus oral steroid daily (prednisone).
Peak Expiratory Flow Rate (HAG):
, Green Yellow Red Zone: - correct answer-
PEF based on Height Age Gender. Blow hard using spirometer highest value recorded.
80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
PPD - correct answer-Neg-
No firm bump forms at the test site, or a bump forms that is smaller than 5 mm (0.2 in.).
Azfirmzbumpzthatzisz5zmmz(0.2zin.)zinzsizezsuggestszazTBzinfectionzinzpeoplezwhozarezinzazhig
h-
riskzgroup.zHIV,zimmunocompromise,zexposed.
Azfirmzbumpzthatzisz10zmmz(0.4zin.)zinzsizezsuggestszazTBzinfectionzinzpeoplezwhozarezinzazmoderat
e-
riskzgroup.zhealthcarezworkers,zimmigrants,zhomeless.
Azfirmzbumpzthatzisz15zmmz(0.6zin.)zinzsizezsuggestszazTBzinfectionzinzpeoplezwhozarezinzazlo
w-
riskzgroupznozriskzforztb.
Digoxinz(CardiaczGlycosides)z-zcorrectzanswer-Therapueticz0.5-2.0
OverdoseztoxcitityzGIzupset,zarrhythmias,zconfusionzvisualzchangesz(yellow/greenztingezvision-
scotomas).zTxzwithzdigibind.zorderzdigzlevel,zelectrolytes,zcreatininezekg.
ThiazidezDiureticsz-zcorrectzanswer-
Ptzwithzbothzhtnzandzosteoporosiszhavezanzextrazbenefitzfromzthiazides.zthiazidezdiureticszdecreasezcalciu
m
excretionzbyzthezkidneyszandzstimulatezosteoclastszformation.zPatientszwithzseriouszsulfazallergieszshouldza
voidzthiazidezdiuretics.zPotassiumzsparingzdiureticszcanzbezusedzaszalternative.
Chlorthalidonez(hygroton),zhydrochlororthiazidez(esidrix,zmicrozide),zindapamidez(lozol),zmetolazonez(zar
oxolyn);zindicatedzforzdecreasedzfluidzvolume,zinexpensive,zeffective,zusefulzinzseverezhypertension,zeffecti
vezorally,zenhanceszotherzantihypertensives;zadversezreactions:zhypokalemiazsymptoms,zhyperuricemia,zglu
coseztolerance,zhypercholesterolemia,zsexualzdysfunction;zobservezforzposturalzhypotension,zcautionzwithzr
NURSE PRACTIOTIONER STUDY GUIDE 2026
WITH COMPLETE SOLUTION
Pheochromocytoma - correct answer-
small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine
, leading to attacks of raised blood pressure, palpitations, and headache. Tx with Alpha blockers
Rovsing's Sign - correct answer-Palpation in LLQ ilicits pain in RLQ indicates appendicitis
NYHA classes of Heart Failure - correct answer-
I No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dy
spnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, pa
lpitation, dyspnea (shortness of breath).
III Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, p
alpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any ph
ysical activity is undertaken, discomfort increases.
Step-wise Approach to Asthma Diagnosis & Treatment - correct answer-Step 1-
Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2 days/week. Albuterol as needed.
Step 2-
Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms > 2 days/week. Albuterol as needed. Lo
w dose ICS ex Flovent. Alt cromolyn, montelukast, nedocromil, theophylline.
Step 3- Mod presistent (FEV1 or PEF 60-
80% predicted. Daily Symptoms. SABA plus low dose ICS or med dose ICS or low dose with leukotriene i
nhibitor (singulair, theophylline, zileuton).
Step 4-
Severe presistent asthma (FEV1/PEF <60% predicted. Symptoms most of day. High dose ICS plus long ac
ting B2 agonist plus oral steroid daily (prednisone).
Peak Expiratory Flow Rate (HAG):
, Green Yellow Red Zone: - correct answer-
PEF based on Height Age Gender. Blow hard using spirometer highest value recorded.
80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
PPD - correct answer-Neg-
No firm bump forms at the test site, or a bump forms that is smaller than 5 mm (0.2 in.).
Azfirmzbumpzthatzisz5zmmz(0.2zin.)zinzsizezsuggestszazTBzinfectionzinzpeoplezwhozarezinzazhig
h-
riskzgroup.zHIV,zimmunocompromise,zexposed.
Azfirmzbumpzthatzisz10zmmz(0.4zin.)zinzsizezsuggestszazTBzinfectionzinzpeoplezwhozarezinzazmoderat
e-
riskzgroup.zhealthcarezworkers,zimmigrants,zhomeless.
Azfirmzbumpzthatzisz15zmmz(0.6zin.)zinzsizezsuggestszazTBzinfectionzinzpeoplezwhozarezinzazlo
w-
riskzgroupznozriskzforztb.
Digoxinz(CardiaczGlycosides)z-zcorrectzanswer-Therapueticz0.5-2.0
OverdoseztoxcitityzGIzupset,zarrhythmias,zconfusionzvisualzchangesz(yellow/greenztingezvision-
scotomas).zTxzwithzdigibind.zorderzdigzlevel,zelectrolytes,zcreatininezekg.
ThiazidezDiureticsz-zcorrectzanswer-
Ptzwithzbothzhtnzandzosteoporosiszhavezanzextrazbenefitzfromzthiazides.zthiazidezdiureticszdecreasezcalciu
m
excretionzbyzthezkidneyszandzstimulatezosteoclastszformation.zPatientszwithzseriouszsulfazallergieszshouldza
voidzthiazidezdiuretics.zPotassiumzsparingzdiureticszcanzbezusedzaszalternative.
Chlorthalidonez(hygroton),zhydrochlororthiazidez(esidrix,zmicrozide),zindapamidez(lozol),zmetolazonez(zar
oxolyn);zindicatedzforzdecreasedzfluidzvolume,zinexpensive,zeffective,zusefulzinzseverezhypertension,zeffecti
vezorally,zenhanceszotherzantihypertensives;zadversezreactions:zhypokalemiazsymptoms,zhyperuricemia,zglu
coseztolerance,zhypercholesterolemia,zsexualzdysfunction;zobservezforzposturalzhypotension,zcautionzwithzr
