Aanp Family Nurse Practitioner Certification Examination Review Questions Complete With 100% Verified Answers And Detailed Rationale

AANP FAMILY NURSE PRACTITIONER CERTIFICATION EXAMINATION REVIEW QUESTIONS COMPLETE WITH 100% VERIFIED ANSWERS AND DETAILED RATIONALE Question 1 A 3-month-old infant with Down syndrome has milk intolerance. The mother switched to goat's milk. The infant now has pale conjunctiva but is otherwise healthy with low HCT. What additional test would you order? A) Vitamin B12 level B) Iron, TIBC C) Folate level D) Reticulocyte count Correct Answer: B) Iron, TIBC Rationale: Goat's milk is low in iron and folate. The infant presents with pallor and low HCT, suggesting iron deficiency anemia. Iron and TIBC would confirm iron deficiency anemia. Vitamin B12 deficiency is less likely as goat's milk contains adequate B12. Folate deficiency is possible but less common than iron deficiency in this scenario. ________________________________________ Question 2 A patient has been on synthroid for 3 months. TSH has increased while T4 remains normal. What should you do? A) Decrease medication B) Maintain current dose C) Increase medication D) Discontinue medication Correct Answer: C) Increase medication Rationale: In hypothyroidism treatment, TSH is the most sensitive marker for adequacy of replacement. An elevated TSH despite normal T4 indicates the patient is still hypothyroid and requires an increased dose of levothyroxine. The medication should be titrated until TSH returns to normal range (typically 0.5-4.5 mIU/L). ________________________________________ Question 3 A 4-month-old infant presents with strabismus. The mother is worried. What should you tell her? A) This requires immediate ophthalmology referral B) This is normal and will resolve C) This indicates a neurologic problem D) This requires patching therapy Correct Answer: B) This is normal and will resolve Rationale: Strabismus (crossed eyes) is normal in infants up to 6 months of age as binocular vision is still developing. After 6 months, persistent strabismus requires evaluation. The nurse practitioner should reassure the mother and monitor for resolution by 6 months. ________________________________________ Question 4 A 4-month-old infant won't keep anything down. What is the main thing you should assess? A) Growth chart B) Electrolyte levels C) Hydration status D) Feeding history Correct Answer: A) Growth chart Rationale: In an infant with persistent vomiting, the most important assessment is growth and weight gain. If the infant is maintaining appropriate growth, it suggests adequate nutrition despite vomiting. This helps distinguish between benign conditions and serious pathology like pyloric stenosis which would cause weight loss. ________________________________________ Question 5 A 6-month-old infant is found to have a closed anterior fontanel. What should you do next? A) Reassure the parents B) Order X-ray C) Measure head circumference D) Refer to neurology Correct Answer: B) Order X-ray Rationale: Premature closure of the anterior fontanel (before 12-18 months) can indicate craniosynostosis. An X-ray of the skull can confirm whether the sutures have fused prematurely. If craniosynostosis is confirmed, surgical referral may be necessary to prevent increased intracranial pressure and allow for normal brain growth. ________________________________________ Question 6 A patient with abnormal cells on Pap smear. What is the appropriate next step? A) Repeat Pap in 6 months B) Refer for colposcopy C) HPV testing D) Endometrial biopsy Correct Answer: B) Refer for colposcopy Rationale: Abnormal Pap smear results, particularly ASCUS, LSIL, or HSIL, require further evaluation with colposcopy. This allows for direct visualization of the cervix and targeted biopsy of any suspicious lesions. HPV testing may be done as triage but colposcopy is the definitive next step for abnormal cytology. ________________________________________ Question 7 What cranial nerves are responsible for extraocular eye movements? A) CN 2, 3, 4 B) CN 3, 4, 6 C) CN 3, 5, 7 D) CN 4, 6, 8 Correct Answer: B) CN 3, 4, 6 Rationale: Extraocular movements are controlled by three cranial nerves: • CN III (Oculomotor): Medial rectus, superior rectus, inferior rectus, inferior oblique • CN IV (Trochlear): Superior oblique • CN VI (Abducens): Lateral rectus The acronym "LR6SO4" helps remember: Lateral rectus = CN6, Superior oblique = CN4. ________________________________________ Question 8 An elderly patient presents with atrophic vaginitis, small uterus, and a palpable 4x5 cm ovary. What should you do next? A) Pelvic ultrasound B) CA-125 level C) Endometrial biopsy D) Observe and re-evaluate in 6 months Correct Answer: A) Pelvic ultrasound Rationale: A palpable ovary in a postmenopausal patient is concerning for malignancy. The current ovarian size (4x5 cm) requires further evaluation. Pelvic ultrasound is the appropriate next step to assess ovarian morphology, size, and vascularity. An ovarian mass in a postmenopausal woman warrants prompt evaluation for possible ovarian cancer. ________________________________________ Question 9 Epistaxis is most common in which area of the nose? A) Posterior septum B) Anterior septum (Kiesselbach's triangle) C) Inferior turbinate D) Superior turbinate Correct Answer: B) Anterior septum (Kiesselbach's triangle) Rationale: Kiesselbach's triangle (Little's area) is located on the anterior nasal septum and contains a rich anastomotic network of blood vessels. This area is the most common site of epistaxis (90%) due to its superficial location and delicate vessels. Posterior bleeds are less common but more serious. ________________________________________ Question 10 What is the definitive diagnosis of acute bacterial prostatitis?