AANP Exam Questions & Answers (100% VERIFIED)
Question 1:
A patient tells the nurse practitioner that she recently started taking the supplement St. John's wort after
reading about its benefits online. Which of the following medications, if being actively consumed, must
be immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)
Answer:
D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and belongs to a drug class known as
serotonin agonists. When used in conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
Question 2:
Which of the following is not a symptom of both major depressive disorder and post-traumatic stress
disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty
Answer:
B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive disorder (MDD) may
also include symptoms of depressed mood, anhedonia, weight loss or gain, and low energy. However,
hypervigilance (B) is not a symptom associated with this diagnosis.
Question 3:
A patient with type 1 diabetes presents for a follow-up visit. He has been stable on his medication
regimen but is worried because he is between jobs and will be without health insurance coverage for a
few months. He asks if there are less expensive insulin options to get him through this time. Which of the
following would be good options for this patient, given his circumstance?
Incorrect A.
Insulin aspart 70/30
B.
Insulin detemir
C.
Insulin isophane
D.
Answer:
Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral protamine Hagedorn
insulin). There are also often pharmacy-specific coupons that can be used on insulin, so helping patients
,Insulin degludec
Answer:
apply for and navigate these programs can be instrumental in managing their diabetes. Another
inexpensive option is regular insulin.Insulin analogs (glargine, detemir, degludec, lispro, and aspart) are
significantly more expensive than human insulin (isophane, regular). Insulins modified by manufacturers,
especially when sold as brand-name medications, tend to be more expensive due to this modification.
While analogs offer alternate lengths of action and convenience, there is no well-documented clinical
evidence that patient outcomes are improved with differing brands. Therefore, maintaining a patient's
blood glucose level through outcome-focused treatment is more valuable than a process-focused plan
based on medication.
Question 4:
A 40-year-old woman with type 2 diabetes presents to the clinic with concerns of spiking blood sugar
between lunch and dinner. She states she is on a rapid-acting insulin sliding scale and long-acting insulin.
Which change should be implemented to help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
Answer:
A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals and as a sliding
scale regimen based on a patient's glucose prior to eating (preprandial). It is the appropriate insulin to
add as a mealtime dose when patients experience blood glucose spikes between meals because of its
short-acting properties. Peak time action of insulin aspart is 2 hours with initial effect within the first 30
minutes, making it an ideal choice to control expected postprandial glycemic spikes
,Question 5:
Which of the following conditions is associated with an increased risk for conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis
Answer:
C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects in the ear canal,
impacted ear wax, tumors, congenital anomalies, discontinuity of middle ear bones, cholesteatoma, and
tympanic membrane rupture. Sound normally travels down the ear canal to vibrate the eardrum
Answer:
(tympanic membrane). The eardrum is connected to three middle ear bones (malleus, incus, and stapes),
which transmit the sound into the inner ear (cochlea). The cochlea is the organ that changes sound
vibrations into a nerve signal that travels to the brain. The four types of hearing loss are conductive,
sensorineural, mixed, and retrocochlear.
Conductive hearing loss occurs when sound cannot effectively reach the inner ear due to issue in the
outer ear and middle ear.
Question 6:
A 23-year-old patient who is pregnant at 28 weeks gestation presents to the clinic for a routine prenatal
checkup. Which fundal height measurement would warrant a more conclusive assessment with an
ultrasound?
A.
26 cm
B.
cm
C.
Answer:
cm
D.
, Question 7:
cm
Answer:
D. 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring tape in centimeters
and should match the gestational age. It can be > or < 2 centimeters and still be within normal limits. A
fundal height of 26-30 cm is a normal finding in a patient who is 28 weeks gestation. A result of 31 cm (D)
is larger than expected and should be further evaluated with an ultrasound.
Question 8:
A 4-year-old boy presents with ear pain and an erythematous, bulging tympanic membrane on
examination. The nurse practitioner diagnoses him with acute otitis media. Which of the following are the
three most common bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
D.
Nontypeable Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae
C. Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
Acute otitis media is commonly encountered by primary care nurse practitioners. Typically, children
present with otalgia and have a bulging tympanic membrane on examination. Many times, children also
have a preceding viral upper respiratory infection, resulting in the colonization of bacteria in the middle
ear and leading to a bacterial infection. Ear infections can be caused by bacterial and viral pathogens. The
most common bacterial pathogens isolated from middle ear fluid are nontypeable Haemophilus
influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae (C). The most common viral pathogens
include respiratory syncytial virus, coronaviruses, influenza viruses, and adenoviruses. Treatment for
acute otitis media should be targeted to combat the most common bacterial causes, including amoxicillin
(penicillin), amoxicillin-clavulanate (penicillin and combination beta-lactam and beta-lactamase inhibitor),
and an oral second-generation cephalosporin (e.g., cefuroxime) in the case of a child with a penicillin
allergy.
A 6-year-old patient presents to the clinic accompanied by his mother, who reports concerns regarding
her child's progressive urinary issues. The patient's mother states that she and the child's father recently
divorced, and the child alternates weekly between her house and his father's house. She reports he
experiences episodes of urinary incontinence and holds his
Answer:
Question 1:
A patient tells the nurse practitioner that she recently started taking the supplement St. John's wort after
reading about its benefits online. Which of the following medications, if being actively consumed, must
be immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)
Answer:
D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and belongs to a drug class known as
serotonin agonists. When used in conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
Question 2:
Which of the following is not a symptom of both major depressive disorder and post-traumatic stress
disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty
Answer:
B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive disorder (MDD) may
also include symptoms of depressed mood, anhedonia, weight loss or gain, and low energy. However,
hypervigilance (B) is not a symptom associated with this diagnosis.
Question 3:
A patient with type 1 diabetes presents for a follow-up visit. He has been stable on his medication
regimen but is worried because he is between jobs and will be without health insurance coverage for a
few months. He asks if there are less expensive insulin options to get him through this time. Which of the
following would be good options for this patient, given his circumstance?
Incorrect A.
Insulin aspart 70/30
B.
Insulin detemir
C.
Insulin isophane
D.
Answer:
Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral protamine Hagedorn
insulin). There are also often pharmacy-specific coupons that can be used on insulin, so helping patients
,Insulin degludec
Answer:
apply for and navigate these programs can be instrumental in managing their diabetes. Another
inexpensive option is regular insulin.Insulin analogs (glargine, detemir, degludec, lispro, and aspart) are
significantly more expensive than human insulin (isophane, regular). Insulins modified by manufacturers,
especially when sold as brand-name medications, tend to be more expensive due to this modification.
While analogs offer alternate lengths of action and convenience, there is no well-documented clinical
evidence that patient outcomes are improved with differing brands. Therefore, maintaining a patient's
blood glucose level through outcome-focused treatment is more valuable than a process-focused plan
based on medication.
Question 4:
A 40-year-old woman with type 2 diabetes presents to the clinic with concerns of spiking blood sugar
between lunch and dinner. She states she is on a rapid-acting insulin sliding scale and long-acting insulin.
Which change should be implemented to help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
Answer:
A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals and as a sliding
scale regimen based on a patient's glucose prior to eating (preprandial). It is the appropriate insulin to
add as a mealtime dose when patients experience blood glucose spikes between meals because of its
short-acting properties. Peak time action of insulin aspart is 2 hours with initial effect within the first 30
minutes, making it an ideal choice to control expected postprandial glycemic spikes
,Question 5:
Which of the following conditions is associated with an increased risk for conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis
Answer:
C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects in the ear canal,
impacted ear wax, tumors, congenital anomalies, discontinuity of middle ear bones, cholesteatoma, and
tympanic membrane rupture. Sound normally travels down the ear canal to vibrate the eardrum
Answer:
(tympanic membrane). The eardrum is connected to three middle ear bones (malleus, incus, and stapes),
which transmit the sound into the inner ear (cochlea). The cochlea is the organ that changes sound
vibrations into a nerve signal that travels to the brain. The four types of hearing loss are conductive,
sensorineural, mixed, and retrocochlear.
Conductive hearing loss occurs when sound cannot effectively reach the inner ear due to issue in the
outer ear and middle ear.
Question 6:
A 23-year-old patient who is pregnant at 28 weeks gestation presents to the clinic for a routine prenatal
checkup. Which fundal height measurement would warrant a more conclusive assessment with an
ultrasound?
A.
26 cm
B.
cm
C.
Answer:
cm
D.
, Question 7:
cm
Answer:
D. 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring tape in centimeters
and should match the gestational age. It can be > or < 2 centimeters and still be within normal limits. A
fundal height of 26-30 cm is a normal finding in a patient who is 28 weeks gestation. A result of 31 cm (D)
is larger than expected and should be further evaluated with an ultrasound.
Question 8:
A 4-year-old boy presents with ear pain and an erythematous, bulging tympanic membrane on
examination. The nurse practitioner diagnoses him with acute otitis media. Which of the following are the
three most common bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
D.
Nontypeable Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae
C. Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
Acute otitis media is commonly encountered by primary care nurse practitioners. Typically, children
present with otalgia and have a bulging tympanic membrane on examination. Many times, children also
have a preceding viral upper respiratory infection, resulting in the colonization of bacteria in the middle
ear and leading to a bacterial infection. Ear infections can be caused by bacterial and viral pathogens. The
most common bacterial pathogens isolated from middle ear fluid are nontypeable Haemophilus
influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae (C). The most common viral pathogens
include respiratory syncytial virus, coronaviruses, influenza viruses, and adenoviruses. Treatment for
acute otitis media should be targeted to combat the most common bacterial causes, including amoxicillin
(penicillin), amoxicillin-clavulanate (penicillin and combination beta-lactam and beta-lactamase inhibitor),
and an oral second-generation cephalosporin (e.g., cefuroxime) in the case of a child with a penicillin
allergy.
A 6-year-old patient presents to the clinic accompanied by his mother, who reports concerns regarding
her child's progressive urinary issues. The patient's mother states that she and the child's father recently
divorced, and the child alternates weekly between her house and his father's house. She reports he
experiences episodes of urinary incontinence and holds his
Answer:
