AANP Actual Exam
AANP Actual Exam, Practice Exam
And Study Guide Newest 2025/2026
With Complete Questions And
Correct Answers |Already Graded
A+||Brand New Version!
A 63-year-old man with a medical history of Lyme disease presents to the clinic for left leg pain
that has been going on for the last few weeks. He states the pain feels like an electric shock
down his left leg and into his foot. He also notes a burning, numb, and tingly sensation in the left
foot intermittently. Which of the following is the most appropriate therapy?
A. Amitriptyline.
B. Methotrexate.
C. Naproxen.
D. Phenelzine.
- Correct Answer :A. Amitriptyline.
Amitriptyline (A) is a tricyclic antidepressant that is used to treat a variety of psychiatric and
neurological diseases. It is a first-line agent to treat neuropathic pain because of its analgesic
properties. Treatment is often multi-disciplinary and should target the root cause of neuropathy.
Physical and occupational therapy are commonly recommended for people with neuropathic
pain to he lp with functional goals.Neuropathic pain can be caused by diabetes, malignancy,
cancer treatment, chronic alcohol use, trauma, and infections such as Lyme disease, HIV, and
herpes zoster. Many neurological disorders also cause neuropathic pain such as stroke sequelae
and multiple sclerosis. Risk factors for developing neuropathic pain include older age, physical
inactivity, manual occupation, and female sex. Methotrexate (B) is a disease-modifying
antirheumatic drug that is commonly used to treat autoimmune disorders such as rheumatoid
arthritis. Naproxen (Aleve) (C) is a nonsteroidal anti-inflammatory drug commonly used to treat
musculoskeletal pain. Phenelzine (Nardil) (D) is a monoamine oxidase inhibitor , a type of
antidepressant.
The nurse practitioner has the patient occlude a nostril and identify a familiar smell. What cranial
nerve is being tested?
A. Cranial nerve I.
B. Cranial nerve IV.
C. Cranial nerve V.
A+ TEST BANK 1
, AANP Actual Exam
D. Cranial nerve XII.
- Correct Answer :A. Cranial nerve I.
The olfactory nerve, or cranial nerve (CN) I (A), is responsible for smell. It is tested by having the
patient occlude a nostril and attempt to identify a familiar smell. Full CN evaluation is an
important part of the neurological examination. CN I examination is rarely performed but can be
easily conducted if desired. Before testing, each nostril should be assessed for patency, as a
blocked nasal passage could alter the test results. The clinician should then have the patient
close their eyes and have them try to identify a common smell. Nonirritating odors should always
be used, with coffee and peppermint being the most commonly used. Both nostrils should be
tested. Sinus infections, head trauma, aging, and Parkinson disease can all cause loss of smell. CN
IV (B) is one of the nerves involved with extraocular movements, and it is tested by having the
patient track the clinician's finger with their eyes. CN V (C) is tested by palpating the muscle tone
of the patient's face and evaluating their facial sensation. CN XII (D) is tested by having the
patient stick out their tongue.
A 30-year-old patient presents to the clinic with a severe, sharp, and stabbing left-sided
headache. The physical examination reveals associated left eye ptosis, conjunctival tearing, and
rhinorrhea, and the patient is pacing the exam room. The most likely diagnosis is:
A. Cluster headache.
B. Migraine.
C. Temporal arteritis.
D. Tension headache
. - Correct Answer :A. Cluster headache.
A cluster headache (A) is a type of trigeminal autonomic cephalgia more commonly seen in
young to middle-aged adults. Excruciating, unilateral pain, sharp or stabbing. Cluster headaches
accompanied by autonomic symptoms, eye ptosis, conjunctival tearing, nasal congestion, and
rhinorrhea on affected side. Restless or agitated, may pace or rock for relief from intense pain.
Rare, but triggered by alcohol & cigarette use. Diagnostic headaches lasting 15min. to 3hrs. 1-2
times daily for several weeks, remission. MRI with contrast to exclude other causes. High-flow
100% oxygen for 15-20 minutes for acute episodes & oral intake of serotonin 5-
hydroxytryptamine type 1 receptor agonist medications, such as sumatriptan (Imitrex), for
abortive care. Preventative options include verapamil (Calan), glucocorticoids, and topiramate
(Topamax). Migraines (B) are characterized by severe, one-sided throbbing pain, often
accompanied by nausea, vomiting, and sensitivity to light or sound. Patients may experience
auras before the headache begins, and unlike cluster headaches, migraines can last for days.
Temporal arteritis (C), also known as giant cell arteritis, typically affects older adults and presents
as a unilateral, pulsating headache located in the temporal region. It is often associated with
scalp tenderness and jaw claudication. Tension headaches (D) often present with bilateral, band-
like pain that is often described as pressure or tightness. The onset is gradual, and the intensity
fluctuates.
A+ TEST BANK 2
, AANP Actual Exam
A 28-year-old patient with a history of migraine headaches presents to the office with concerns
about ineffective migraine control. The patient states that ibuprofen (Motrin) previously
alleviated their symptoms, but it has been ineffective during recent migraine episodes. The nurse
practitioner should prescribe:
A. Hydrocodone-Acetaminophen (Lortab).
B. Sumatriptan (Imitrex).
C. Lasmiditan.
D. Phenobarbital (Sezaby)
. - Correct Answer :B. Sumatriptan (Imitrex).
Migraines severe with nausea, sound sensitivity, & photophobia. First-line nonopioid analgesics,
ibuprofen (Motrin), naproxen (Aleve), & acetaminophen (Tylenol). If ineffective, triptan
sumatriptan (Imitrex) (B).
More frequently in women, strong genetic basis. Mostly in third decade of life, exacerbated by
stress, hormones, eating patterns, sleep disturbances, & alcohol use. Four phases prodrome,
aura, headache, and postdrome phases. The neurologic examination is typically normal in
patients with migraine headaches. Preventive treatment antihypertensives, antidepressants, &
anticonvulsants. And calcitonin gene-related peptide antagonists, lasmiditan, and
dihydroergotamine. Any patients with an abnormal neurologic examination or atypical headache
features may require neuroimaging for evaluation of other underlying etiologies for the
headache. Opioids (e.g., hydrocodone-acetaminophen [Lortab] [A]) not recommended except as
a last resort. Less effective than migraine-specific medications associated with
dependenc/misuse. Lasmiditan (C) is a medication used to treat migraines. Due to its
vasoconstrictor activity, lasmiditan may be used in patients with relative contraindications to
triptans due to cardiovascular risk factors, but it would not be considered next for the patient in
this clinical vignette. Like opioids, barbiturates (e.g., phenobarbital [Sezaby] [D]) are not
recommended to treat migraines except as a last resort.
A 74-year-old woman presents to the office for an annual physical exam. She is accompanied by
her children who voice concerns about their mother's memory. A Mini-Cog test is administered,
and the results show possible Alzheimer disease. The nurse practitioner understands that
Alzheimer disease is associated with which of the following neurologic pathologies?
A. Beta-amyloid plaque deposits & protein tangles.
B. Ischemic damage from atherosclerotic plaques.
C. Loss of dopamine in basal ganglia.
D. Widespread demyelination of nerve fibers.
- Correct Answer :A. Beta-amyloid plaque deposits & protein tangles.
Alzheimer disease (AD) is characterized by deposits of beta-amyloid plaques and neurofibrillary
tau protein tangles (A) in the brain. The true cause of AD is unknown, but a genetic
predisposition is suspected. AD makes up for 60-80% of all forms of dementia. It should be
A+ TEST BANK 3
, AANP Actual Exam
distinguished from age-related cognitive impairment and other causes of dementia, including
Lewy body disease and vascular dementia. AD should also be distinguished from delirium and
other reversible causes of cognitive decline, such as infection, autoimmune disease, metabolic
imbalances, substance use, or depression.AD is most common in older women. Risk factors
include smoking, hypertension, hyperlipidemia, tobacco use, and stroke. Other modifiable risk
factors include excessive alcohol consumption, poor quality sleep, less than eighth grade
education, later life depression, and lack of social engagement. Imaging and testing for
biomarkers (beta-amyloid plaques and tau protein) can be helpful for diagnosis. Ischemic
damage due to atherosclerotic plaques, bleeding, or blood clots (B) indicates vascular dementia,
which happens secondary to stroke. Loss of dopamine receptors in the basal ganglia (C) indicates
Parkinson disease. Widespread demyelination of nerve fibers in the white matter (D) is seen in
multiple sclerosis.
An 89-year-old patient with a history of advanced Alzheimer disease presents to the clinic for
follow-up. Their primary caregiver shares that the patient is no longer able to recognize close
family members, including their adult children, even during extended visits. Which of the
following terms best describes this cognitive finding?
A. Agnosia.
B. Amnesia.
C. Aphasia.
D. Apraxia.
- Correct Answer :A. Agnosia.
This is the inability to recognize or process sensory information, including faces, objects, sounds,
or bodily signals. In this case, the patient's inability to recognize their children is a form of visual
agnosia, can occur in later stages of Alzheimer disease. Or show as loss of awareness of internal
sensations such as bladder fullness, which can contribute to urinary incontinence.AD is a
progressive, neurodegenerative condition. It is the most common form of dementia and
primarily affects patients who are 65 years and older. Memory impairment is the cardinal feature
of AD. Other cognitive deficits may affect executive function, speech and language abilities, and
activities of daily living. Neuropsychiatric and behavioral changes may occur. AD is diagnosed by
comprehensive clinical assessment, laboratory evaluation, neuropsychiatric testing, and
advanced diagnostic imaging of the brain. Amnesia (B) is memory loss and would more likely
present as forgetting recent events or conversations, not difficulty recognizing people. Aphasia
(C) involves impairment in language expression or comprehension, not recognition of familiar
faces. Apraxia (D) is the inability to perform purposeful motor tasks, despite intact physical
ability.
A 25-year-old patient presents for follow-up for migraines. They have no headache today but
report that they have had four migraine headaches in the past month. Which of the following
medications should be prescribed to this patient for prophylaxis?
A. Ergotamine (Ergomar).
A+ TEST BANK 4
AANP Actual Exam, Practice Exam
And Study Guide Newest 2025/2026
With Complete Questions And
Correct Answers |Already Graded
A+||Brand New Version!
A 63-year-old man with a medical history of Lyme disease presents to the clinic for left leg pain
that has been going on for the last few weeks. He states the pain feels like an electric shock
down his left leg and into his foot. He also notes a burning, numb, and tingly sensation in the left
foot intermittently. Which of the following is the most appropriate therapy?
A. Amitriptyline.
B. Methotrexate.
C. Naproxen.
D. Phenelzine.
- Correct Answer :A. Amitriptyline.
Amitriptyline (A) is a tricyclic antidepressant that is used to treat a variety of psychiatric and
neurological diseases. It is a first-line agent to treat neuropathic pain because of its analgesic
properties. Treatment is often multi-disciplinary and should target the root cause of neuropathy.
Physical and occupational therapy are commonly recommended for people with neuropathic
pain to he lp with functional goals.Neuropathic pain can be caused by diabetes, malignancy,
cancer treatment, chronic alcohol use, trauma, and infections such as Lyme disease, HIV, and
herpes zoster. Many neurological disorders also cause neuropathic pain such as stroke sequelae
and multiple sclerosis. Risk factors for developing neuropathic pain include older age, physical
inactivity, manual occupation, and female sex. Methotrexate (B) is a disease-modifying
antirheumatic drug that is commonly used to treat autoimmune disorders such as rheumatoid
arthritis. Naproxen (Aleve) (C) is a nonsteroidal anti-inflammatory drug commonly used to treat
musculoskeletal pain. Phenelzine (Nardil) (D) is a monoamine oxidase inhibitor , a type of
antidepressant.
The nurse practitioner has the patient occlude a nostril and identify a familiar smell. What cranial
nerve is being tested?
A. Cranial nerve I.
B. Cranial nerve IV.
C. Cranial nerve V.
A+ TEST BANK 1
, AANP Actual Exam
D. Cranial nerve XII.
- Correct Answer :A. Cranial nerve I.
The olfactory nerve, or cranial nerve (CN) I (A), is responsible for smell. It is tested by having the
patient occlude a nostril and attempt to identify a familiar smell. Full CN evaluation is an
important part of the neurological examination. CN I examination is rarely performed but can be
easily conducted if desired. Before testing, each nostril should be assessed for patency, as a
blocked nasal passage could alter the test results. The clinician should then have the patient
close their eyes and have them try to identify a common smell. Nonirritating odors should always
be used, with coffee and peppermint being the most commonly used. Both nostrils should be
tested. Sinus infections, head trauma, aging, and Parkinson disease can all cause loss of smell. CN
IV (B) is one of the nerves involved with extraocular movements, and it is tested by having the
patient track the clinician's finger with their eyes. CN V (C) is tested by palpating the muscle tone
of the patient's face and evaluating their facial sensation. CN XII (D) is tested by having the
patient stick out their tongue.
A 30-year-old patient presents to the clinic with a severe, sharp, and stabbing left-sided
headache. The physical examination reveals associated left eye ptosis, conjunctival tearing, and
rhinorrhea, and the patient is pacing the exam room. The most likely diagnosis is:
A. Cluster headache.
B. Migraine.
C. Temporal arteritis.
D. Tension headache
. - Correct Answer :A. Cluster headache.
A cluster headache (A) is a type of trigeminal autonomic cephalgia more commonly seen in
young to middle-aged adults. Excruciating, unilateral pain, sharp or stabbing. Cluster headaches
accompanied by autonomic symptoms, eye ptosis, conjunctival tearing, nasal congestion, and
rhinorrhea on affected side. Restless or agitated, may pace or rock for relief from intense pain.
Rare, but triggered by alcohol & cigarette use. Diagnostic headaches lasting 15min. to 3hrs. 1-2
times daily for several weeks, remission. MRI with contrast to exclude other causes. High-flow
100% oxygen for 15-20 minutes for acute episodes & oral intake of serotonin 5-
hydroxytryptamine type 1 receptor agonist medications, such as sumatriptan (Imitrex), for
abortive care. Preventative options include verapamil (Calan), glucocorticoids, and topiramate
(Topamax). Migraines (B) are characterized by severe, one-sided throbbing pain, often
accompanied by nausea, vomiting, and sensitivity to light or sound. Patients may experience
auras before the headache begins, and unlike cluster headaches, migraines can last for days.
Temporal arteritis (C), also known as giant cell arteritis, typically affects older adults and presents
as a unilateral, pulsating headache located in the temporal region. It is often associated with
scalp tenderness and jaw claudication. Tension headaches (D) often present with bilateral, band-
like pain that is often described as pressure or tightness. The onset is gradual, and the intensity
fluctuates.
A+ TEST BANK 2
, AANP Actual Exam
A 28-year-old patient with a history of migraine headaches presents to the office with concerns
about ineffective migraine control. The patient states that ibuprofen (Motrin) previously
alleviated their symptoms, but it has been ineffective during recent migraine episodes. The nurse
practitioner should prescribe:
A. Hydrocodone-Acetaminophen (Lortab).
B. Sumatriptan (Imitrex).
C. Lasmiditan.
D. Phenobarbital (Sezaby)
. - Correct Answer :B. Sumatriptan (Imitrex).
Migraines severe with nausea, sound sensitivity, & photophobia. First-line nonopioid analgesics,
ibuprofen (Motrin), naproxen (Aleve), & acetaminophen (Tylenol). If ineffective, triptan
sumatriptan (Imitrex) (B).
More frequently in women, strong genetic basis. Mostly in third decade of life, exacerbated by
stress, hormones, eating patterns, sleep disturbances, & alcohol use. Four phases prodrome,
aura, headache, and postdrome phases. The neurologic examination is typically normal in
patients with migraine headaches. Preventive treatment antihypertensives, antidepressants, &
anticonvulsants. And calcitonin gene-related peptide antagonists, lasmiditan, and
dihydroergotamine. Any patients with an abnormal neurologic examination or atypical headache
features may require neuroimaging for evaluation of other underlying etiologies for the
headache. Opioids (e.g., hydrocodone-acetaminophen [Lortab] [A]) not recommended except as
a last resort. Less effective than migraine-specific medications associated with
dependenc/misuse. Lasmiditan (C) is a medication used to treat migraines. Due to its
vasoconstrictor activity, lasmiditan may be used in patients with relative contraindications to
triptans due to cardiovascular risk factors, but it would not be considered next for the patient in
this clinical vignette. Like opioids, barbiturates (e.g., phenobarbital [Sezaby] [D]) are not
recommended to treat migraines except as a last resort.
A 74-year-old woman presents to the office for an annual physical exam. She is accompanied by
her children who voice concerns about their mother's memory. A Mini-Cog test is administered,
and the results show possible Alzheimer disease. The nurse practitioner understands that
Alzheimer disease is associated with which of the following neurologic pathologies?
A. Beta-amyloid plaque deposits & protein tangles.
B. Ischemic damage from atherosclerotic plaques.
C. Loss of dopamine in basal ganglia.
D. Widespread demyelination of nerve fibers.
- Correct Answer :A. Beta-amyloid plaque deposits & protein tangles.
Alzheimer disease (AD) is characterized by deposits of beta-amyloid plaques and neurofibrillary
tau protein tangles (A) in the brain. The true cause of AD is unknown, but a genetic
predisposition is suspected. AD makes up for 60-80% of all forms of dementia. It should be
A+ TEST BANK 3
, AANP Actual Exam
distinguished from age-related cognitive impairment and other causes of dementia, including
Lewy body disease and vascular dementia. AD should also be distinguished from delirium and
other reversible causes of cognitive decline, such as infection, autoimmune disease, metabolic
imbalances, substance use, or depression.AD is most common in older women. Risk factors
include smoking, hypertension, hyperlipidemia, tobacco use, and stroke. Other modifiable risk
factors include excessive alcohol consumption, poor quality sleep, less than eighth grade
education, later life depression, and lack of social engagement. Imaging and testing for
biomarkers (beta-amyloid plaques and tau protein) can be helpful for diagnosis. Ischemic
damage due to atherosclerotic plaques, bleeding, or blood clots (B) indicates vascular dementia,
which happens secondary to stroke. Loss of dopamine receptors in the basal ganglia (C) indicates
Parkinson disease. Widespread demyelination of nerve fibers in the white matter (D) is seen in
multiple sclerosis.
An 89-year-old patient with a history of advanced Alzheimer disease presents to the clinic for
follow-up. Their primary caregiver shares that the patient is no longer able to recognize close
family members, including their adult children, even during extended visits. Which of the
following terms best describes this cognitive finding?
A. Agnosia.
B. Amnesia.
C. Aphasia.
D. Apraxia.
- Correct Answer :A. Agnosia.
This is the inability to recognize or process sensory information, including faces, objects, sounds,
or bodily signals. In this case, the patient's inability to recognize their children is a form of visual
agnosia, can occur in later stages of Alzheimer disease. Or show as loss of awareness of internal
sensations such as bladder fullness, which can contribute to urinary incontinence.AD is a
progressive, neurodegenerative condition. It is the most common form of dementia and
primarily affects patients who are 65 years and older. Memory impairment is the cardinal feature
of AD. Other cognitive deficits may affect executive function, speech and language abilities, and
activities of daily living. Neuropsychiatric and behavioral changes may occur. AD is diagnosed by
comprehensive clinical assessment, laboratory evaluation, neuropsychiatric testing, and
advanced diagnostic imaging of the brain. Amnesia (B) is memory loss and would more likely
present as forgetting recent events or conversations, not difficulty recognizing people. Aphasia
(C) involves impairment in language expression or comprehension, not recognition of familiar
faces. Apraxia (D) is the inability to perform purposeful motor tasks, despite intact physical
ability.
A 25-year-old patient presents for follow-up for migraines. They have no headache today but
report that they have had four migraine headaches in the past month. Which of the following
medications should be prescribed to this patient for prophylaxis?
A. Ergotamine (Ergomar).
A+ TEST BANK 4
