AANP AGPCNP PSI 2025 EXAM 1 & 2 LATEST
QUESTIONS AND DETAILED CORRECT ANSWERS
(VERIFIED ANSWERS) | A+ GRADE 2025/2026
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise,
fever, night sweats, and a cough that has been present for 4 weeks. The
diagnostic study to perform first would be:
1) xray
2) pulmonary function test
3) bronchoscopy
4) H & H - ans -1) xray (tb-night sweats)
A 44-year-old female is complaining of frequent anxiety attacks with chest
discomfort and fatigue. On physical examination, her lungs are clear bilaterally.
There are a midsystolic click and a grade II/VI systolic murmur at the apex. Further
evaluation would include which of the following?
1) EKG, flat plate of the abdomen, lipid profile
2) Echocardiogram, Doppler, EKG
3) Labs and benzo's
4) EEG, Anxiety Scale, and electrolytes - ans -2) Echocardiogram, Doppler, EKG
A healthy 84 y/o would like to start an exercise program, what would you do
before this takes place?
1) physical exam
2) EKG
3) knee xrays
4) PT Stress test - ans -1) Physical Exam
29 y/o has uncomplicated Chlamydia infection will exhibit:
1) green penile discharge
,2) uticartia
3) unremarkable symtpoms
4) penile ulcer - ans -3) unremarkable symptoms
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
1) spirometry
2) MRI
3) COntract venogra[hy
4) helical CT pulmonary angiograph - ans -4) helical CT pulmonary angiography.
A 12-lead EKG shows an undulating baseline with no visible P waves and an
irregularly irregular R-R interval. This arrhythmia is:
1) atrial flutter
2) atrial fibrillation
3) second degree heart block
4) Wolff-White Syndrome - ans -2) atrial fibrillation
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central
clearing, located in the inguinal area. The patient has had a severe headache,
malaise, fatigue, and generalized musculoskeletal pain for several days.
Pharmacologic management of this condition includes:
1) Bactrim
2) azithromycin
3) doxycycline (Doryx).
4) metronidazole - ans -3) doxycycline (Doryx). Rocky Mountain spotted fever
(Lyme disease-test with WEstern Blot)
According to the American Diabetes Association, the newest standard for
determining the presence of diabetes mellitus based on fasting plasma sugar level
is a value equal to or greater than:
1) 110 mg/dL.
,2) 126 mg/dL.
3) 135
4) whatever - ans -2) 126 mg/dl
In the elderly, one pathophysiologic mechanism of isolated systolic hypertension
involves:
1) decreased cardiac output.
2) loss of vascular tissue elasticity.
3) hyperactive baroreceptors - ans -2) loss of vascular tissue elasticity
A 58-year-old female presents with shoulder and pelvic girdle pain for the past 6
months. She reports recent unintentional weight loss. On physical examination,
there is pain on ROM, with no weakness noted. Laboratory studies show a low
hemoglobin and an elevated sedimentation rate. Which of the following is the
most likely diagnosis?
1) Polymyalgia rheumatica
2) polymyositis
3) osteoarthritis
4) Fibromyalgia - ans -1) polymyalgia rheumatica
An 85-year-old male relates that on the way to his annual physical examination,
he suffered a sudden loss of vision in his right eye characterized by "a bunch of
lights" and a feeling that "a curtain came down." All of the following would be
included in the differential diagnosis EXCEPT:
1) opthalmolic migraine
2) retinal detachment.
3) diabetic retinopathy.
4) TIA - ans -3) diabetic retinopathy
A patient with diabetes mellitus who is on NPH and regular insulin split-dosing
presents with complaints of early morning rise in fingerstick blood glucose. A
review of self blood glucose monitoring reveals increased morning levels. After an
, increase in the evening insulin dose, the problem worsens. This is most likely an
example of:
1) insulin resistance
2) the Somogyi effect.
3) needing more insulin in the mornings
4) Need to increase insulin at night - ans -2) Somogyi effect
In a healthy elder, which of the following TRADITIONALLY defines a positive urine
culture?
1) ≥100,000 colonies/mL of a single organism
2) ≥10,000 colonies/mL of a single organism
3) ≥100,000 colonies/mL of a two or more organisms - ans -≥100,000 colonies/mL
of a single organism
A 55-year-old patient exhibits a verified serum calcium level of 13 mg/dL [normal
= 8.9-10.2 mg/dL]. The next step in determining the presence of pathology is to
order a:
1) BUN and serum creatinine.
2) 24 hour urine
3) parathyroid hormone level.
4) thyroid panel - ans -3) parathyroid hormone level
An 88-year-old female presents with a 3-day history of vertigo. The patient has a
past medical history of hypertension controlled with metoprolol, 50 mg daily. She
reports that the presenting symptoms are constant, severe, and accompanied by
nausea and vomiting. She denies experiencing diplopia, slurring of speech, chest
pain, dyspnea, or diaphoresis. She exhibits mild anxiety and reluctance to change
position or turn the head. BP = 126/76; P = 78; R = 16/min; and T = 98.2°F
(36.8°C). HEENT examination reveals 17 beats of horizontal nystagmus on right
lateral gaze; the nystagmus stops after several repetitions of the maneuver.
Funduscopic, cardiac, pulmonary, abdominal, and neurologic examination results
are normal. The most likely diagnosis is:
QUESTIONS AND DETAILED CORRECT ANSWERS
(VERIFIED ANSWERS) | A+ GRADE 2025/2026
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise,
fever, night sweats, and a cough that has been present for 4 weeks. The
diagnostic study to perform first would be:
1) xray
2) pulmonary function test
3) bronchoscopy
4) H & H - ans -1) xray (tb-night sweats)
A 44-year-old female is complaining of frequent anxiety attacks with chest
discomfort and fatigue. On physical examination, her lungs are clear bilaterally.
There are a midsystolic click and a grade II/VI systolic murmur at the apex. Further
evaluation would include which of the following?
1) EKG, flat plate of the abdomen, lipid profile
2) Echocardiogram, Doppler, EKG
3) Labs and benzo's
4) EEG, Anxiety Scale, and electrolytes - ans -2) Echocardiogram, Doppler, EKG
A healthy 84 y/o would like to start an exercise program, what would you do
before this takes place?
1) physical exam
2) EKG
3) knee xrays
4) PT Stress test - ans -1) Physical Exam
29 y/o has uncomplicated Chlamydia infection will exhibit:
1) green penile discharge
,2) uticartia
3) unremarkable symtpoms
4) penile ulcer - ans -3) unremarkable symptoms
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
1) spirometry
2) MRI
3) COntract venogra[hy
4) helical CT pulmonary angiograph - ans -4) helical CT pulmonary angiography.
A 12-lead EKG shows an undulating baseline with no visible P waves and an
irregularly irregular R-R interval. This arrhythmia is:
1) atrial flutter
2) atrial fibrillation
3) second degree heart block
4) Wolff-White Syndrome - ans -2) atrial fibrillation
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central
clearing, located in the inguinal area. The patient has had a severe headache,
malaise, fatigue, and generalized musculoskeletal pain for several days.
Pharmacologic management of this condition includes:
1) Bactrim
2) azithromycin
3) doxycycline (Doryx).
4) metronidazole - ans -3) doxycycline (Doryx). Rocky Mountain spotted fever
(Lyme disease-test with WEstern Blot)
According to the American Diabetes Association, the newest standard for
determining the presence of diabetes mellitus based on fasting plasma sugar level
is a value equal to or greater than:
1) 110 mg/dL.
,2) 126 mg/dL.
3) 135
4) whatever - ans -2) 126 mg/dl
In the elderly, one pathophysiologic mechanism of isolated systolic hypertension
involves:
1) decreased cardiac output.
2) loss of vascular tissue elasticity.
3) hyperactive baroreceptors - ans -2) loss of vascular tissue elasticity
A 58-year-old female presents with shoulder and pelvic girdle pain for the past 6
months. She reports recent unintentional weight loss. On physical examination,
there is pain on ROM, with no weakness noted. Laboratory studies show a low
hemoglobin and an elevated sedimentation rate. Which of the following is the
most likely diagnosis?
1) Polymyalgia rheumatica
2) polymyositis
3) osteoarthritis
4) Fibromyalgia - ans -1) polymyalgia rheumatica
An 85-year-old male relates that on the way to his annual physical examination,
he suffered a sudden loss of vision in his right eye characterized by "a bunch of
lights" and a feeling that "a curtain came down." All of the following would be
included in the differential diagnosis EXCEPT:
1) opthalmolic migraine
2) retinal detachment.
3) diabetic retinopathy.
4) TIA - ans -3) diabetic retinopathy
A patient with diabetes mellitus who is on NPH and regular insulin split-dosing
presents with complaints of early morning rise in fingerstick blood glucose. A
review of self blood glucose monitoring reveals increased morning levels. After an
, increase in the evening insulin dose, the problem worsens. This is most likely an
example of:
1) insulin resistance
2) the Somogyi effect.
3) needing more insulin in the mornings
4) Need to increase insulin at night - ans -2) Somogyi effect
In a healthy elder, which of the following TRADITIONALLY defines a positive urine
culture?
1) ≥100,000 colonies/mL of a single organism
2) ≥10,000 colonies/mL of a single organism
3) ≥100,000 colonies/mL of a two or more organisms - ans -≥100,000 colonies/mL
of a single organism
A 55-year-old patient exhibits a verified serum calcium level of 13 mg/dL [normal
= 8.9-10.2 mg/dL]. The next step in determining the presence of pathology is to
order a:
1) BUN and serum creatinine.
2) 24 hour urine
3) parathyroid hormone level.
4) thyroid panel - ans -3) parathyroid hormone level
An 88-year-old female presents with a 3-day history of vertigo. The patient has a
past medical history of hypertension controlled with metoprolol, 50 mg daily. She
reports that the presenting symptoms are constant, severe, and accompanied by
nausea and vomiting. She denies experiencing diplopia, slurring of speech, chest
pain, dyspnea, or diaphoresis. She exhibits mild anxiety and reluctance to change
position or turn the head. BP = 126/76; P = 78; R = 16/min; and T = 98.2°F
(36.8°C). HEENT examination reveals 17 beats of horizontal nystagmus on right
lateral gaze; the nystagmus stops after several repetitions of the maneuver.
Funduscopic, cardiac, pulmonary, abdominal, and neurologic examination results
are normal. The most likely diagnosis is:
