AANP Exam-Questions and Correct Answers (Expert verified/ Latest Update
2024/2025/100% Pass
A patient tells the nurse practitioner that she recently started taking the supplement St. John's wort
after reading about its benefits online. Which of the following medications, if being actively
consumed, must be immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex) - ✔✔D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and belongs to a drug class known
as serotonin agonists. When used in conjunction with St. John's wort, it may increase the risk of
serotonin syndrome, a potentially life-threatening condition.
Which of the following is not a symptom of both major depressive disorder and post-traumatic
stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty - ✔✔B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive disorder (MDD)
may also include symptoms of depressed mood, anhedonia, weight loss or gain, and low energy.
However, hypervigilance (B) is not a symptom associated with this diagnosis.
A patient with type 1 diabetes presents for a follow-up visit. He has been stable on his medication
regimen but is worried because he is between jobs and will be without health insurance coverage for
a few months. He asks if there are less expensive insulin options to get him through this time. Which
of the following would be good options for this patient, given his circumstance?
Incorrect
A.
Insulin aspart 70/30
,B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec - ✔✔Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral protamine
Hagedorn insulin). There are also often pharmacy-specific coupons that can be used on insulin, so
helping patients apply for and navigate these programs can be instrumental in managing their
diabetes. Another inexpensive option is regular insulin.Insulin analogs (glargine, detemir, degludec,
lispro, and aspart) are significantly more expensive than human insulin (isophane, regular). Insulins
modified by manufacturers, especially when sold as brand-name medications, tend to be more
expensive due to this modification. While analogs offer alternate lengths of action and convenience,
there is no well-documented clinical evidence that patient outcomes are improved with differing
brands. Therefore, maintaining a patient's blood glucose level through outcome-focused treatment
is more valuable than a process-focused plan based on medication.
A 40-year-old woman with type 2 diabetes presents to the clinic with concerns of spiking blood sugar
between lunch and dinner. She states she is on a rapid-acting insulin sliding scale and long-acting
insulin. Which change should be implemented to help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
,Prescribe a dose of neutral protamine Hagedorn insulin with dinner - ✔✔A. Add a dose of mealtime
insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals and as a
sliding scale regimen based on a patient's glucose prior to eating (preprandial). It is the appropriate
insulin to add as a mealtime dose when patients experience blood glucose spikes between meals
because of its short-acting properties. Peak time action of insulin aspart is 2 hours with initial effect
within the first 30 minutes, making it an ideal choice to control expected postprandial glycemic
spikes
Which of the following conditions is associated with an increased risk for conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis - ✔✔C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects in the ear canal,
impacted ear wax, tumors, congenital anomalies, discontinuity of middle ear bones, cholesteatoma,
and tympanic membrane rupture. Sound normally travels down the ear canal to vibrate the eardrum
(tympanic membrane). The eardrum is connected to three middle ear bones (malleus, incus, and
stapes), which transmit the sound into the inner ear (cochlea). The cochlea is the organ that changes
sound vibrations into a nerve signal that travels to the brain. The four types of hearing loss are
conductive, sensorineural, mixed, and retrocochlear. Conductive hearing loss occurs when sound
cannot effectively reach the inner ear due to issue in the outer ear and middle ear.
A 23-year-old patient who is pregnant at 28 weeks gestation presents to the clinic for a routine
prenatal checkup. Which fundal height measurement would warrant a more conclusive assessment
with an ultrasound?
, A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm - ✔✔D. 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring tape in
centimeters and should match the gestational age. It can be > or < 2 centimeters and still be within
normal limits. A fundal height of 26-30 cm is a normal finding in a patient who is 28 weeks gestation.
A result of 31 cm (D) is larger than expected and should be further evaluated with an ultrasound.
A 4-year-old boy presents with ear pain and an erythematous, bulging tympanic membrane on
examination. The nurse practitioner diagnoses him with acute otitis media. Which of the following
are the three most common bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
D.
2024/2025/100% Pass
A patient tells the nurse practitioner that she recently started taking the supplement St. John's wort
after reading about its benefits online. Which of the following medications, if being actively
consumed, must be immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex) - ✔✔D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and belongs to a drug class known
as serotonin agonists. When used in conjunction with St. John's wort, it may increase the risk of
serotonin syndrome, a potentially life-threatening condition.
Which of the following is not a symptom of both major depressive disorder and post-traumatic
stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty - ✔✔B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive disorder (MDD)
may also include symptoms of depressed mood, anhedonia, weight loss or gain, and low energy.
However, hypervigilance (B) is not a symptom associated with this diagnosis.
A patient with type 1 diabetes presents for a follow-up visit. He has been stable on his medication
regimen but is worried because he is between jobs and will be without health insurance coverage for
a few months. He asks if there are less expensive insulin options to get him through this time. Which
of the following would be good options for this patient, given his circumstance?
Incorrect
A.
Insulin aspart 70/30
,B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec - ✔✔Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral protamine
Hagedorn insulin). There are also often pharmacy-specific coupons that can be used on insulin, so
helping patients apply for and navigate these programs can be instrumental in managing their
diabetes. Another inexpensive option is regular insulin.Insulin analogs (glargine, detemir, degludec,
lispro, and aspart) are significantly more expensive than human insulin (isophane, regular). Insulins
modified by manufacturers, especially when sold as brand-name medications, tend to be more
expensive due to this modification. While analogs offer alternate lengths of action and convenience,
there is no well-documented clinical evidence that patient outcomes are improved with differing
brands. Therefore, maintaining a patient's blood glucose level through outcome-focused treatment
is more valuable than a process-focused plan based on medication.
A 40-year-old woman with type 2 diabetes presents to the clinic with concerns of spiking blood sugar
between lunch and dinner. She states she is on a rapid-acting insulin sliding scale and long-acting
insulin. Which change should be implemented to help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
,Prescribe a dose of neutral protamine Hagedorn insulin with dinner - ✔✔A. Add a dose of mealtime
insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals and as a
sliding scale regimen based on a patient's glucose prior to eating (preprandial). It is the appropriate
insulin to add as a mealtime dose when patients experience blood glucose spikes between meals
because of its short-acting properties. Peak time action of insulin aspart is 2 hours with initial effect
within the first 30 minutes, making it an ideal choice to control expected postprandial glycemic
spikes
Which of the following conditions is associated with an increased risk for conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis - ✔✔C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects in the ear canal,
impacted ear wax, tumors, congenital anomalies, discontinuity of middle ear bones, cholesteatoma,
and tympanic membrane rupture. Sound normally travels down the ear canal to vibrate the eardrum
(tympanic membrane). The eardrum is connected to three middle ear bones (malleus, incus, and
stapes), which transmit the sound into the inner ear (cochlea). The cochlea is the organ that changes
sound vibrations into a nerve signal that travels to the brain. The four types of hearing loss are
conductive, sensorineural, mixed, and retrocochlear. Conductive hearing loss occurs when sound
cannot effectively reach the inner ear due to issue in the outer ear and middle ear.
A 23-year-old patient who is pregnant at 28 weeks gestation presents to the clinic for a routine
prenatal checkup. Which fundal height measurement would warrant a more conclusive assessment
with an ultrasound?
, A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm - ✔✔D. 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring tape in
centimeters and should match the gestational age. It can be > or < 2 centimeters and still be within
normal limits. A fundal height of 26-30 cm is a normal finding in a patient who is 28 weeks gestation.
A result of 31 cm (D) is larger than expected and should be further evaluated with an ultrasound.
A 4-year-old boy presents with ear pain and an erythematous, bulging tympanic membrane on
examination. The nurse practitioner diagnoses him with acute otitis media. Which of the following
are the three most common bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
D.
