AANP Review Exam Questions & Answers
1.A 64 year old with HTN and DM presents with productive cough, fever,
body aches. What diagnosis is most likely?
a. Acute bronchitis
b. Chronic bronchitis
c. Pneumonia
d. Pertussis: c. Pneumonia
1st clue: 64 year old
2nd clue: multiple
comorbidities 3rd clue:
cough, fever
what was the stem of the question?
2.Indications for a chest xray with acute cough: abnormal vital signs
(increased RR or HR, temp >38c, 100.4F
rales, consolidation
> or equal 75 years of age with cough***
***Pneumonia in older patient: tachypnea, decreased O2 sat, OR change
in mental status or behavior
,3.A 75 year old patient wo smokes and has COPD presents with a
worsening cough, weight loss, fatigue, and an enlarged right supraclavicular
node. Which finding is most indicative of a right lung tumor?
1. worsening cough
2. weight loss
3. fatigue
4. supraclavicular node: 4. supraclavicular node
most important stem clue because this lymph node drains the chest
and breast. It's a BIG deal!
If the stem gives a unilateral finding, look for a unilateral diagnosis
4.What symptoms most commonly accompany acute bronchitis?
1. Fever, runny nose
2. Cough, fever
3. Cough and URI symptoms
4. Cough, URI, and headache: 3. Cough and URI symptoms
Remember that bronchitis is an inflammation of the bronchioles, bronchi
and trachea; usually follows an upper respiratory infection
Starts above the shoulders and drops down into chest.
5.A 35 year old patient with acute bronchitis has no underlying lung
,disease. He asks, "How long before my cough goes aways?" The NP
responds:
1. <1 week
2. about 1 week
3. 1-3 weeks
4. >3 weeks: 3. 1-3 weeks
The patient with bronchitis will have evidence of upper AND lower airway
symptoms. COUGH, COUGH, COUGH, usually worse at night!
6.What is the management of bronchitis?: Treat
symptoms! Time is the only thing for bronchitis
ABX usually prescribed, but usually not necessary
7.Differential Diagnosis for Acute Bronchitis:
PND Asthma
PNA
Pertussi
s TB
8.Supraclavicular nodes: associated with high rates of malignancy.
What organs are on the right vs left?: RT: Lungs, mediastinum,
esophagus
LT: Abdominal malignancy: stomach GB liver pancreas ovaries prostate
, 9.Pneumonia
Vaccine Who?
Who else?
When is it given again?: Who-Prevention: Pneumococcal polysaccharide
vaccina- tion (PPSV) given once in a lifetime to immunocompetent
adults > or equal 65 years Who else-Adults 19-64 with
--chronic CV, lung, liver disease
--smokers, DM, ETOH, or asplenic
--chronic care facilities
--immunocompromising conditions
When again-one time 5 years after for CRF, nephrotic syndrome,
asplenia, sickle cell, immunocompromising conditions
10.A 52 year old feale was recently diagnosed with RA. She is being
treated with a DMARD.
Should she receive PPSV? If so, should she receive another one, and if so
when?
1. Yes, in 5 years
2. No, another is not needed
3. Yes, at 65 years old
4. Yes, at age 60 years: Yes, in 5 years
11.What are some presentation symptoms for
pneumonia? What is the classical presentation?: Cough
(>90%)
1.A 64 year old with HTN and DM presents with productive cough, fever,
body aches. What diagnosis is most likely?
a. Acute bronchitis
b. Chronic bronchitis
c. Pneumonia
d. Pertussis: c. Pneumonia
1st clue: 64 year old
2nd clue: multiple
comorbidities 3rd clue:
cough, fever
what was the stem of the question?
2.Indications for a chest xray with acute cough: abnormal vital signs
(increased RR or HR, temp >38c, 100.4F
rales, consolidation
> or equal 75 years of age with cough***
***Pneumonia in older patient: tachypnea, decreased O2 sat, OR change
in mental status or behavior
,3.A 75 year old patient wo smokes and has COPD presents with a
worsening cough, weight loss, fatigue, and an enlarged right supraclavicular
node. Which finding is most indicative of a right lung tumor?
1. worsening cough
2. weight loss
3. fatigue
4. supraclavicular node: 4. supraclavicular node
most important stem clue because this lymph node drains the chest
and breast. It's a BIG deal!
If the stem gives a unilateral finding, look for a unilateral diagnosis
4.What symptoms most commonly accompany acute bronchitis?
1. Fever, runny nose
2. Cough, fever
3. Cough and URI symptoms
4. Cough, URI, and headache: 3. Cough and URI symptoms
Remember that bronchitis is an inflammation of the bronchioles, bronchi
and trachea; usually follows an upper respiratory infection
Starts above the shoulders and drops down into chest.
5.A 35 year old patient with acute bronchitis has no underlying lung
,disease. He asks, "How long before my cough goes aways?" The NP
responds:
1. <1 week
2. about 1 week
3. 1-3 weeks
4. >3 weeks: 3. 1-3 weeks
The patient with bronchitis will have evidence of upper AND lower airway
symptoms. COUGH, COUGH, COUGH, usually worse at night!
6.What is the management of bronchitis?: Treat
symptoms! Time is the only thing for bronchitis
ABX usually prescribed, but usually not necessary
7.Differential Diagnosis for Acute Bronchitis:
PND Asthma
PNA
Pertussi
s TB
8.Supraclavicular nodes: associated with high rates of malignancy.
What organs are on the right vs left?: RT: Lungs, mediastinum,
esophagus
LT: Abdominal malignancy: stomach GB liver pancreas ovaries prostate
, 9.Pneumonia
Vaccine Who?
Who else?
When is it given again?: Who-Prevention: Pneumococcal polysaccharide
vaccina- tion (PPSV) given once in a lifetime to immunocompetent
adults > or equal 65 years Who else-Adults 19-64 with
--chronic CV, lung, liver disease
--smokers, DM, ETOH, or asplenic
--chronic care facilities
--immunocompromising conditions
When again-one time 5 years after for CRF, nephrotic syndrome,
asplenia, sickle cell, immunocompromising conditions
10.A 52 year old feale was recently diagnosed with RA. She is being
treated with a DMARD.
Should she receive PPSV? If so, should she receive another one, and if so
when?
1. Yes, in 5 years
2. No, another is not needed
3. Yes, at 65 years old
4. Yes, at age 60 years: Yes, in 5 years
11.What are some presentation symptoms for
pneumonia? What is the classical presentation?: Cough
(>90%)
