ANCC AGPCNP Practice Question with
answers
An 18-year-old female patient is being followed up for acne by the nurse
practitioner. During the facial exam, papules and pustules are noted mostly on the
forehead and the chin areas. The patient has been using over-the-counter topical
antibiotic gels and medicated soap daily for 6 months without much improvement.
The nurse practitioner will recommend:
a. Isotretinoin (Accutane)
b. Tetracycline (Sumycin)
c. Clindamycin topical solution (Cleocin- T)
d. Minoxidil (Rogaine) - -b. Tetracycline (Sumycin)
First-line treatment for acne vulgaris includes over-the-counter medicated soap and
water with topical antibiotic gels. The next step in treatment would be the initiation
of oral tetracycline.
-A young adult presents for reassessment of uncontrolled asthma symptoms. The
patient is currently taking an inhaled short-acting beta2-agonist (SABA) as needed
and reports daytime symptoms more than 3 days/week, but not daily, and nighttime
awakenings 4 to 5 times/week. The patient's forced expiratory volume (FEV1) is
80% of predicted. The nurse practitioner upgrades the patient to the next stage of
treatment, which includes:
a. Budesonide with formoterol
b. Budesonide with montelukast
c. Cromolyn or nedocromil
d. Fluticasone with salmeterol - -a. Budesonide with formoterol.
The patient has moved from step 2 to step 3 on the asthma classification scale.
Therefore, a low-dose inhaled corticosteroid (ICS) plus long-acting beta-agonist
(LABA) such as budesonide with formoterol is an appropriate starting point.
Fluticasone with salmeterol is prescribed if the patient is at step 4; budesonide with
montelukast is an alternative. Cromolyn and nedocromil have been discontinued in
the United States.
-Which of the following drugs can increase the risk of bleeding in patients who are
receiving anticoagulation therapy with warfarin sodium (Coumadin)?
a. Trimethoprim-sulfamethoxazole (Bactrim DS)
b. Carafate (Sucralfate)
c. Losartan (Cozaar)
d. Furosemide (Lasix) - -a. Trimethoprim-sulfamethoxazole (Bactrim DS).
Warfarin sodium (Coumadin) interacts with Bactrim and will increase the risk of
bleeding; therefore, concurrent use is contraindicated.
,-A 22-year-old woman is going on a 5-day cruise for her honeymoon. She reports a
history of severe motion sickness. Which of the following medicines can be
prescribed for motion sickness?
a. Dimenhydrinate (Dramamine)
b. Metoclopramide (Reglan)
c. Ondansetron (Zofran)
d. Scopolamine patch (Transderm Scop) - -d. Scopolamine patch (Transderm Scop)
Scopolamine patch (Transderm Scop) is a prescription medicine that is used for
motion/sea sickness. It is a small, circular patch that is placed behind the ear and is
effective for 3 days. Advise the patient to apply it 4 hours before the trip to be
effective. Because the question is asking about a "prescribed" medication, an over-
the-counter (OTC) medicine, such as Dramamine, is an incorrect response. Zofran is
indicated for cancer-related nausea and vomiting (chemotherapy, radiation,
surgery).
-The nurse practitioner is completing a health assessment on a 15-year-old female
patient who is in the office for her annual physical. The patient reports feelings of
hopelessness and sadness for several months, no history of suicidal ideations, and a
struggle with anorexia. The patient scores an 11 on Beck's Depression Inventory.
Which antidepressant will the nurse practitioner prescribe?
a. Sertraline (Zoloft)
b. Lithium carbonate (Eskalith)
c. Bupropion (Wellbutrin)
d. Escitalopram (Lexapro) - -d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe depression
and no history of suicidal ideations. Sertraline is not a safe option for patients
younger than 24 years of age because of increased risk of suicidal ideation.
Bupropion is an atypical antidepressant and is not a first-line therapy for
depression. It is contraindicated in patients with anorexia nervosa. Lithium is
indicated for patients with bipolar disorder.
-Which initial treatment will the nurse practitioner prescribe to a 23-year-old female
allergic to sulfa drugs who is diagnosed with acute cystitis?
a. Cephalexin (Keflex) 500 mg BID × 5 days
b. Ciprofloxacin (Cipro) 250 mg BID × 3 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
d. Amoxicillin 500 mg BID × 5 days - -c. Nitrofurantoin (Macrobid) 100 mg BID × 5
days
Nitrofurantoin can be safely administered to a patient with a sulfa allergy to treat
acute cystitis and is the first line of treatment. Cephalexin and amoxicillin are beta-
lactam antibiotics that can be prescribed for a patient who has an allergy to sulfa
and nitrofurantoin. A fluoroquinolone, such as ciprofloxacin, is recommended for a
patient who is allergic to sulfa and beta-lactam drugs or has a sulfa allergy and a
known resistance to beta-lactam antibiotics.
, -A 68-year-old patient recently prescribed caridopa-levodopa (Sinemet) tells the
nurse practitioner that he has been bloated and experiencing difficulty with bowel
movements. Which medication will the nurse practitioner consider incorporating
into the treatment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol - -d. Polyethylene glycol
Levodopa, an antiparkinsonian drug, can cause constipation in an older patient. The
first-line treatment for the patient's constipation is osmotic laxatives such as
polyethylene glycol. Senna is a stimulant laxative that is a second-line treatment for
constipation in an older adult. Methylnaltrexone is a peripherally acting mu-opioid
antagonist that acts on the gastrointestinal tract to decrease opioid-induced
constipation. Magnesium-based laxatives (e.g., magnesium citrate) taken over the
long term should be avoided because of the potential of toxicity.
-A patient recently returned from a trip to Africa and is experiencing 10 to 12 loose
stools every day. The patient takes metformin every morning and otherwise is in
good health. Which medication will the nurse practitioner prescribe to treat the
diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose - -d. Ciprofloxacin in a single dose
The patient most likely has traveler's diarrhea, given the history of a recent return
from another country. The patient's treatment should be based on functional impact
of symptoms and not frequency of symptoms, which is not indicated in the
question. The patient likely has moderate acute traveler's diarrhea, which can be
treated with loperamide as monotherapy or with adjunctive antibiotic therapy. The
patient is taking metformin daily for diabetes, so risk of precipitating hypoglycemia
is lower than with other oral antidiabetic agents. Because it can be given in a single
dose, ciprofloxacin would be the appropriate choice for reducing exposure and
microbiome colonization disruption. Levofloxacin and ofloxacin require one to three
doses. Trimethoprim-sulfamethoxazole is a sulfonamide and would be appropriate
treatment for cyclosporiasis but not giardiasis, which is the most common parasitic
cause of traveler's diarrhea.
-A patient newly diagnosed with diabetes reports severe hives and swollen lips
after taking Bactrim for a bladder infection 2 months ago. Which of the following
statements is correct?
a. The patient cannot take any pills in the sulfonylurea class
b. The patient can take some of the pills in the sulfonylurea class
c. The patient can take any of the pills in the sulfonylurea class
answers
An 18-year-old female patient is being followed up for acne by the nurse
practitioner. During the facial exam, papules and pustules are noted mostly on the
forehead and the chin areas. The patient has been using over-the-counter topical
antibiotic gels and medicated soap daily for 6 months without much improvement.
The nurse practitioner will recommend:
a. Isotretinoin (Accutane)
b. Tetracycline (Sumycin)
c. Clindamycin topical solution (Cleocin- T)
d. Minoxidil (Rogaine) - -b. Tetracycline (Sumycin)
First-line treatment for acne vulgaris includes over-the-counter medicated soap and
water with topical antibiotic gels. The next step in treatment would be the initiation
of oral tetracycline.
-A young adult presents for reassessment of uncontrolled asthma symptoms. The
patient is currently taking an inhaled short-acting beta2-agonist (SABA) as needed
and reports daytime symptoms more than 3 days/week, but not daily, and nighttime
awakenings 4 to 5 times/week. The patient's forced expiratory volume (FEV1) is
80% of predicted. The nurse practitioner upgrades the patient to the next stage of
treatment, which includes:
a. Budesonide with formoterol
b. Budesonide with montelukast
c. Cromolyn or nedocromil
d. Fluticasone with salmeterol - -a. Budesonide with formoterol.
The patient has moved from step 2 to step 3 on the asthma classification scale.
Therefore, a low-dose inhaled corticosteroid (ICS) plus long-acting beta-agonist
(LABA) such as budesonide with formoterol is an appropriate starting point.
Fluticasone with salmeterol is prescribed if the patient is at step 4; budesonide with
montelukast is an alternative. Cromolyn and nedocromil have been discontinued in
the United States.
-Which of the following drugs can increase the risk of bleeding in patients who are
receiving anticoagulation therapy with warfarin sodium (Coumadin)?
a. Trimethoprim-sulfamethoxazole (Bactrim DS)
b. Carafate (Sucralfate)
c. Losartan (Cozaar)
d. Furosemide (Lasix) - -a. Trimethoprim-sulfamethoxazole (Bactrim DS).
Warfarin sodium (Coumadin) interacts with Bactrim and will increase the risk of
bleeding; therefore, concurrent use is contraindicated.
,-A 22-year-old woman is going on a 5-day cruise for her honeymoon. She reports a
history of severe motion sickness. Which of the following medicines can be
prescribed for motion sickness?
a. Dimenhydrinate (Dramamine)
b. Metoclopramide (Reglan)
c. Ondansetron (Zofran)
d. Scopolamine patch (Transderm Scop) - -d. Scopolamine patch (Transderm Scop)
Scopolamine patch (Transderm Scop) is a prescription medicine that is used for
motion/sea sickness. It is a small, circular patch that is placed behind the ear and is
effective for 3 days. Advise the patient to apply it 4 hours before the trip to be
effective. Because the question is asking about a "prescribed" medication, an over-
the-counter (OTC) medicine, such as Dramamine, is an incorrect response. Zofran is
indicated for cancer-related nausea and vomiting (chemotherapy, radiation,
surgery).
-The nurse practitioner is completing a health assessment on a 15-year-old female
patient who is in the office for her annual physical. The patient reports feelings of
hopelessness and sadness for several months, no history of suicidal ideations, and a
struggle with anorexia. The patient scores an 11 on Beck's Depression Inventory.
Which antidepressant will the nurse practitioner prescribe?
a. Sertraline (Zoloft)
b. Lithium carbonate (Eskalith)
c. Bupropion (Wellbutrin)
d. Escitalopram (Lexapro) - -d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe depression
and no history of suicidal ideations. Sertraline is not a safe option for patients
younger than 24 years of age because of increased risk of suicidal ideation.
Bupropion is an atypical antidepressant and is not a first-line therapy for
depression. It is contraindicated in patients with anorexia nervosa. Lithium is
indicated for patients with bipolar disorder.
-Which initial treatment will the nurse practitioner prescribe to a 23-year-old female
allergic to sulfa drugs who is diagnosed with acute cystitis?
a. Cephalexin (Keflex) 500 mg BID × 5 days
b. Ciprofloxacin (Cipro) 250 mg BID × 3 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
d. Amoxicillin 500 mg BID × 5 days - -c. Nitrofurantoin (Macrobid) 100 mg BID × 5
days
Nitrofurantoin can be safely administered to a patient with a sulfa allergy to treat
acute cystitis and is the first line of treatment. Cephalexin and amoxicillin are beta-
lactam antibiotics that can be prescribed for a patient who has an allergy to sulfa
and nitrofurantoin. A fluoroquinolone, such as ciprofloxacin, is recommended for a
patient who is allergic to sulfa and beta-lactam drugs or has a sulfa allergy and a
known resistance to beta-lactam antibiotics.
, -A 68-year-old patient recently prescribed caridopa-levodopa (Sinemet) tells the
nurse practitioner that he has been bloated and experiencing difficulty with bowel
movements. Which medication will the nurse practitioner consider incorporating
into the treatment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol - -d. Polyethylene glycol
Levodopa, an antiparkinsonian drug, can cause constipation in an older patient. The
first-line treatment for the patient's constipation is osmotic laxatives such as
polyethylene glycol. Senna is a stimulant laxative that is a second-line treatment for
constipation in an older adult. Methylnaltrexone is a peripherally acting mu-opioid
antagonist that acts on the gastrointestinal tract to decrease opioid-induced
constipation. Magnesium-based laxatives (e.g., magnesium citrate) taken over the
long term should be avoided because of the potential of toxicity.
-A patient recently returned from a trip to Africa and is experiencing 10 to 12 loose
stools every day. The patient takes metformin every morning and otherwise is in
good health. Which medication will the nurse practitioner prescribe to treat the
diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose - -d. Ciprofloxacin in a single dose
The patient most likely has traveler's diarrhea, given the history of a recent return
from another country. The patient's treatment should be based on functional impact
of symptoms and not frequency of symptoms, which is not indicated in the
question. The patient likely has moderate acute traveler's diarrhea, which can be
treated with loperamide as monotherapy or with adjunctive antibiotic therapy. The
patient is taking metformin daily for diabetes, so risk of precipitating hypoglycemia
is lower than with other oral antidiabetic agents. Because it can be given in a single
dose, ciprofloxacin would be the appropriate choice for reducing exposure and
microbiome colonization disruption. Levofloxacin and ofloxacin require one to three
doses. Trimethoprim-sulfamethoxazole is a sulfonamide and would be appropriate
treatment for cyclosporiasis but not giardiasis, which is the most common parasitic
cause of traveler's diarrhea.
-A patient newly diagnosed with diabetes reports severe hives and swollen lips
after taking Bactrim for a bladder infection 2 months ago. Which of the following
statements is correct?
a. The patient cannot take any pills in the sulfonylurea class
b. The patient can take some of the pills in the sulfonylurea class
c. The patient can take any of the pills in the sulfonylurea class
