AANP|VERIFIED QUESTIONS AND CORRECT DETAILED ANSWERS|RATED AND
GRADED A+ NEW UPDATE| 2026/2027
Therapeutic INR values below ____ increase stroke risk sixfold. - ANSWER✔ 2
Diabetic Retinopathy Findings - ANSWER✔ Microaneurysms
Neovascularization
Cotton Wool Spots
Hard exudates
All of the following would require the nurse practitioner to delay testing a patient's prostate-specific
antigen (PSA), except:
a. Urinary retention
b. Urinary tract infection
c. After a digital rectal exam
d. Vigorous exercise 3 days prior - ANSWER✔ Vigorous exercise 3 days prior
PSA testing is falsely elevated in a patient with urinary retention and urinary tract infection and after a
digital rectal exam. Vigorous exercise does not have to be stopped 3 days prior to testing; however,
vigorous exercise should be discouraged before testing because it will falsely elevate the PSA levels.
Ejaculation within 48 hours will also falsely raise the PSA level.
Tic Douloureaux - ANSWER✔ There are two types of tic douloureux (trigeminal neuralgia).
Type 1--presents with extreme, shock-like facial pain, which lasts from a few seconds to 2 minutes per
event and can last up to 2 hours total. Type 1 does not awaken the patient at night.
Type 2-- is a constant, aching, burning facial pain with less intensity but may occur with Type 1. Type 2 is
more common in women and peaks in their 60s. Type 2 can also be related to secondary neurologic
disease such as multiple sclerosis or HSV-1.
,The nurse practitioner sees a 58-year-old female patient who reports abscesses and pustules in the axilla
and groin and under the breasts, which burst and drain purulent green discharge. She has a history of
smoking and a body mass index (BMI) of 37.1.
Which diagnosis is most likely?
a. Impetigo
b. Carbuncles
c. Shingles
d. Hidradenitis suppurativa - ANSWER✔ hidradenitis suppurativa
Hidradenitis suppurativa is most common in women (3:1). Smoking and obesity are significant risk
factors. Lesions are treated with topical antibiotics (or oral antibiotics, warm compresses, and pain
medications). Institute diet changes to reduce high glycemic and dairy food intake. Refer to a
dermatologist for additional treatment options.
Insulin Lispro (Humalog) - ANSWER✔ Lispro is a rapid-acting insulin that is used on a sliding scale to
work from meal to meal
Atopic dermatitis (eczema) - ANSWER✔ chronic, pruritic rash of the hands, flexural folds, and neck
that can be exacerbated by stress and environmental factors.
Toxic Epidermal Necrolysis (TEN) - ANSWER✔ TEN is the result of a severe skin reaction to
medications such as allopurinol, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticonvulsants.
Melanoma - ANSWER✔ Melanoma are nevi with uneven texture, irregular borders, variegated colors,
size larger than 6 mm, and changing size (the mnemonic ABCDE stands for asymmetry, border
irregularity, color variations in the same region, diameter >6 mm, and enlargement or change in size
over time), and they can be pruritic. Risk factors include family history of melanoma (10% of cases),
extensive/intense sunlight exposure, blistering sunburn in childhood, tanning beds, and atypical nevus
,Seborrheic keratoses - ANSWER✔ Seborrheic keratoses are soft, fleshy, painless growths that are
located mostly on the back. Skin lesions look like they are "pasted" on the skin and can range in color
from light tan to black.
Acanthosis nigricans - ANSWER✔ Acanthosis nigricans are diffuse, soft thickenings of the skin usually
located at the neck and axilla. They are also associated with diabetes, metabolic syndrome, obesity, and
gastrointestinal cancer.
Acrochordon - ANSWER✔ Acrochordons (skin tags) are painless, pedunculated outgrowths of skin
that are common in the neck and axillary areas. If the growths are traumatized, they become necrotic
and fall off. They are most common in diabetics and patients who are obese.
Which of the following is associated with male aging?
a. Increased levels of estrogen
b. Decreased sperm production
c. Increased production of semen
d. Decreased concentration of sperm - ANSWER✔ Decreased sperm production
A nurse practitioner sees a patient for an evaluation of sexually transmitted diseases. Assessment
reveals Fitz-Hugh-Curtis. The nurse practitioner will prescribe: - ANSWER✔ Ceftriaxone 500 mg IM ×
one dose plus doxycycline 100 mg BID × 14 days plus metronidazole 500 mg BID × 14 days.
Fitz-Hugh-Curtis syndrome should be treated as a complicated gonorrheal/chlamydial infection:
Ceftriaxone 500 mg IM × one dose plus doxycycline 100 mg BID × 14 days plus metronidazole 500 mg
BID × 14 days for anaerobic coverage.
sensitive screening test for HIV - ANSWER✔ Combination HIV-1 and HIV-2 antibody immunoassay
with p24 antigen.
DM medication class that should not be used in patients with heart failure or hx of bladder cancer? -
ANSWER✔ Thiazolidinediones
, Medication class with high risk of hypoglycemic events: - ANSWER✔ Sulfonylureas stimulate the beta
cells but have a long half-life, and there is a high risk for severe hypoglycemic events.
Treponema pallidum - ANSWER✔ T. pallidum is a gram-negative spirochete bacterium that causes
syphilis.
Which class of diuretics is contraindicated in patients who are allergic to sulfa products? - ANSWER✔
Thiazides (hydrochlorothiazide and indapamide) and loop diuretics (furosemide and bumetanide) are
contraindicated in patients with sulfa allergies.
Hypertensive Retinopathy Findings - ANSWER✔ - silver wire/copper wire arterioles.
- AV nicking
Bullous Myringitis - ANSWER✔ Small vesicles containing blood on the drum; accompany mycoplasma
pneumonia and virus infections
Bullous myringitis is an ear infection in which small, fluid-filled blisters form on the eardrum. This finding
distinguishes this diagnosis.
PCOS puts the patient at additional risk for: - ANSWER✔ metabolic syndrome, Type II DM, and
infertility because of the high levels of androgens in the body
What to monitor in thiazide diuretics? - ANSWER✔ Side effects of thiazide diuretics such as
hydrochlorothiazide are hyperglycemia, hyperuricemia, and hypertriglyceridemia and
hypercholesteremia. Patients should also be monitored for hypokalemia, hyponatremia (not
hypernatremia), and hypomagnesemia.
Giant Cell Arteritis (Temporal Arteritis) - ANSWER✔ Causes an acute headache in one temple area
with an indurated, reddened temporal artery and scalp tenderness. A major complication of this
condition is transient blindness (amaurosis fugax) of the affected eye. A patient may experience jaw
claudication from the artery obstruction, and elevated ESR and CRP rates are expected with an
inflammatory process.
GRADED A+ NEW UPDATE| 2026/2027
Therapeutic INR values below ____ increase stroke risk sixfold. - ANSWER✔ 2
Diabetic Retinopathy Findings - ANSWER✔ Microaneurysms
Neovascularization
Cotton Wool Spots
Hard exudates
All of the following would require the nurse practitioner to delay testing a patient's prostate-specific
antigen (PSA), except:
a. Urinary retention
b. Urinary tract infection
c. After a digital rectal exam
d. Vigorous exercise 3 days prior - ANSWER✔ Vigorous exercise 3 days prior
PSA testing is falsely elevated in a patient with urinary retention and urinary tract infection and after a
digital rectal exam. Vigorous exercise does not have to be stopped 3 days prior to testing; however,
vigorous exercise should be discouraged before testing because it will falsely elevate the PSA levels.
Ejaculation within 48 hours will also falsely raise the PSA level.
Tic Douloureaux - ANSWER✔ There are two types of tic douloureux (trigeminal neuralgia).
Type 1--presents with extreme, shock-like facial pain, which lasts from a few seconds to 2 minutes per
event and can last up to 2 hours total. Type 1 does not awaken the patient at night.
Type 2-- is a constant, aching, burning facial pain with less intensity but may occur with Type 1. Type 2 is
more common in women and peaks in their 60s. Type 2 can also be related to secondary neurologic
disease such as multiple sclerosis or HSV-1.
,The nurse practitioner sees a 58-year-old female patient who reports abscesses and pustules in the axilla
and groin and under the breasts, which burst and drain purulent green discharge. She has a history of
smoking and a body mass index (BMI) of 37.1.
Which diagnosis is most likely?
a. Impetigo
b. Carbuncles
c. Shingles
d. Hidradenitis suppurativa - ANSWER✔ hidradenitis suppurativa
Hidradenitis suppurativa is most common in women (3:1). Smoking and obesity are significant risk
factors. Lesions are treated with topical antibiotics (or oral antibiotics, warm compresses, and pain
medications). Institute diet changes to reduce high glycemic and dairy food intake. Refer to a
dermatologist for additional treatment options.
Insulin Lispro (Humalog) - ANSWER✔ Lispro is a rapid-acting insulin that is used on a sliding scale to
work from meal to meal
Atopic dermatitis (eczema) - ANSWER✔ chronic, pruritic rash of the hands, flexural folds, and neck
that can be exacerbated by stress and environmental factors.
Toxic Epidermal Necrolysis (TEN) - ANSWER✔ TEN is the result of a severe skin reaction to
medications such as allopurinol, nonsteroidal anti-inflammatory drugs (NSAIDs), and anticonvulsants.
Melanoma - ANSWER✔ Melanoma are nevi with uneven texture, irregular borders, variegated colors,
size larger than 6 mm, and changing size (the mnemonic ABCDE stands for asymmetry, border
irregularity, color variations in the same region, diameter >6 mm, and enlargement or change in size
over time), and they can be pruritic. Risk factors include family history of melanoma (10% of cases),
extensive/intense sunlight exposure, blistering sunburn in childhood, tanning beds, and atypical nevus
,Seborrheic keratoses - ANSWER✔ Seborrheic keratoses are soft, fleshy, painless growths that are
located mostly on the back. Skin lesions look like they are "pasted" on the skin and can range in color
from light tan to black.
Acanthosis nigricans - ANSWER✔ Acanthosis nigricans are diffuse, soft thickenings of the skin usually
located at the neck and axilla. They are also associated with diabetes, metabolic syndrome, obesity, and
gastrointestinal cancer.
Acrochordon - ANSWER✔ Acrochordons (skin tags) are painless, pedunculated outgrowths of skin
that are common in the neck and axillary areas. If the growths are traumatized, they become necrotic
and fall off. They are most common in diabetics and patients who are obese.
Which of the following is associated with male aging?
a. Increased levels of estrogen
b. Decreased sperm production
c. Increased production of semen
d. Decreased concentration of sperm - ANSWER✔ Decreased sperm production
A nurse practitioner sees a patient for an evaluation of sexually transmitted diseases. Assessment
reveals Fitz-Hugh-Curtis. The nurse practitioner will prescribe: - ANSWER✔ Ceftriaxone 500 mg IM ×
one dose plus doxycycline 100 mg BID × 14 days plus metronidazole 500 mg BID × 14 days.
Fitz-Hugh-Curtis syndrome should be treated as a complicated gonorrheal/chlamydial infection:
Ceftriaxone 500 mg IM × one dose plus doxycycline 100 mg BID × 14 days plus metronidazole 500 mg
BID × 14 days for anaerobic coverage.
sensitive screening test for HIV - ANSWER✔ Combination HIV-1 and HIV-2 antibody immunoassay
with p24 antigen.
DM medication class that should not be used in patients with heart failure or hx of bladder cancer? -
ANSWER✔ Thiazolidinediones
, Medication class with high risk of hypoglycemic events: - ANSWER✔ Sulfonylureas stimulate the beta
cells but have a long half-life, and there is a high risk for severe hypoglycemic events.
Treponema pallidum - ANSWER✔ T. pallidum is a gram-negative spirochete bacterium that causes
syphilis.
Which class of diuretics is contraindicated in patients who are allergic to sulfa products? - ANSWER✔
Thiazides (hydrochlorothiazide and indapamide) and loop diuretics (furosemide and bumetanide) are
contraindicated in patients with sulfa allergies.
Hypertensive Retinopathy Findings - ANSWER✔ - silver wire/copper wire arterioles.
- AV nicking
Bullous Myringitis - ANSWER✔ Small vesicles containing blood on the drum; accompany mycoplasma
pneumonia and virus infections
Bullous myringitis is an ear infection in which small, fluid-filled blisters form on the eardrum. This finding
distinguishes this diagnosis.
PCOS puts the patient at additional risk for: - ANSWER✔ metabolic syndrome, Type II DM, and
infertility because of the high levels of androgens in the body
What to monitor in thiazide diuretics? - ANSWER✔ Side effects of thiazide diuretics such as
hydrochlorothiazide are hyperglycemia, hyperuricemia, and hypertriglyceridemia and
hypercholesteremia. Patients should also be monitored for hypokalemia, hyponatremia (not
hypernatremia), and hypomagnesemia.
Giant Cell Arteritis (Temporal Arteritis) - ANSWER✔ Causes an acute headache in one temple area
with an indurated, reddened temporal artery and scalp tenderness. A major complication of this
condition is transient blindness (amaurosis fugax) of the affected eye. A patient may experience jaw
claudication from the artery obstruction, and elevated ESR and CRP rates are expected with an
inflammatory process.
