AANP AGPCNP PSI TEST 1 & 2 FINAL EXAM
QUESTIONS WITH CORRECT ANSWERS
An 88-year-old presents with right-
side weakness after being unable to rise unassisted following a fall to the bathroom floor. History inclu
des aphasia and noncompliance with hypertension medication regimen. What is the most likely diagnos
is?
Left-sided or right-sided CVA? - correct answer-LEFT-SIDED CVA
Which of the following signs/symtpoms are often associated with headahces due to intracranial tumor?
1) pain worse laying down, focal neurological signs
2) Hyperflexia, personality change
3) acute onset: hours to days
4) pupillary constriction; stupor - correct answer-1) pain worse laying down, focal neurological signs
Which of the following pharmacotherapeutics would be most important to administer to a patient who
has a corneal abrasion?
1) Timolol
2) Gentamicin ophthalmic
3) Cromolyn optha
4) Olopatadine - correct answer-2) Gentamicin ophthalmic (Genoptic)
A 25-year-
old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated
by movement. The patient reports that he participated in extensive house painting 24 hours prior to the
onset of pain. He denies any trauma. Passive ROM is intact. No redness or ecchymosis is present. Wh
at is the next step to be taken in order to make a diagnosis?
1) Xray of shoulder
,2) Palpate structures around the shoulder.
3) MRI of shoulder
4) EMG - correct answer-2) palpate structures
A 16-year-old female in the first month of taking Ortho-
Novum 7/7/7 complains of midcycle spotting. She has not missed any doses and uses no other medicat
ion. Which of the following is appropriate?
1) Changing to Ortho-Novum 1/35
2) Discontinue use
3) Providing reassurance
4) Double dose-for two days - correct answer-3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a
current recommendation guideline for preventive care in elderly female patients?
1) Mammogram and clinical breast exams
2) Fecal Occult blood test and/or sig
3) Rubella serology or vaccination history
4) Pnuemo and influenza vaccines - correct answer-3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, RA10. The best act
ion is to:
1) initiate passive warming
2) apply a rebreather
3) Perform fluid replacement
4) initiate active warming - correct answer-1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would you ed
ucate this patient on recognizing the signs and symptoms of hypoglycemia?
,1) Edema
2) Tachycardia
3) palpitations
4) sweating - correct answer-4) sweating
A 65-year-
old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs, stretching, ice, an
d rest has proven ineffective after 3 weeks. The best follow-up plan of care would be to:
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
2) continue NSAID, apply an arch support and encourage wt loss and exercise
3) continue NSAID, xray and add a short-leg night splint
4) COntinue NSAID, xray and add a metatarsal bar - correct answer-
2) continue NSAID, apply an arch support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
1) nicking of arteriols and viens, and small retinol hemorrages
2) drusen bodies and pale retina
3) pale macula and swollen disk margins
4) microaneurysms and optic disc cupping - correct answer-
1) nicking of arteriols and viens, and small retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
3) atrial fibrillation
4) abnormal T3 suppression - correct answer-3) atrial fibrillation
A 35-year-
old lawn maintenance worker presents reporting "something in my eye" since the previous day. The ey
, e was rinsed with over-the-
counter eyewash, without relief. The patient denies visual disturbances or drainage. In formulating a pl
an of care, the nurse practitioner would FIRST:
1) send to ophthalmologists
2) florescreen staining
3) test visual field
4) prescribe eyedrops - correct answer-3) test visual field
A 72-year-
old patient presents with dry, itchy eyes. During the course of the physical examination, the nurse pract
itioner notes the presence of a gray band of opacity in the cornea that encircles the iris. The band is 1.
0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
1. corneal abrasion
2. arcus senilis
3. corneal ulcer
4. herpetic infection of the eye - correct answer-2) arcus senilis
A 26-year-
old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and a cough tha
t 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 - correct answer-1) xray (tb-night sweats)
A 44-year-
old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On physical e
xamination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI systolic mur
mur at the apex. Further evaluation would include which of the following?
QUESTIONS WITH CORRECT ANSWERS
An 88-year-old presents with right-
side weakness after being unable to rise unassisted following a fall to the bathroom floor. History inclu
des aphasia and noncompliance with hypertension medication regimen. What is the most likely diagnos
is?
Left-sided or right-sided CVA? - correct answer-LEFT-SIDED CVA
Which of the following signs/symtpoms are often associated with headahces due to intracranial tumor?
1) pain worse laying down, focal neurological signs
2) Hyperflexia, personality change
3) acute onset: hours to days
4) pupillary constriction; stupor - correct answer-1) pain worse laying down, focal neurological signs
Which of the following pharmacotherapeutics would be most important to administer to a patient who
has a corneal abrasion?
1) Timolol
2) Gentamicin ophthalmic
3) Cromolyn optha
4) Olopatadine - correct answer-2) Gentamicin ophthalmic (Genoptic)
A 25-year-
old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated
by movement. The patient reports that he participated in extensive house painting 24 hours prior to the
onset of pain. He denies any trauma. Passive ROM is intact. No redness or ecchymosis is present. Wh
at is the next step to be taken in order to make a diagnosis?
1) Xray of shoulder
,2) Palpate structures around the shoulder.
3) MRI of shoulder
4) EMG - correct answer-2) palpate structures
A 16-year-old female in the first month of taking Ortho-
Novum 7/7/7 complains of midcycle spotting. She has not missed any doses and uses no other medicat
ion. Which of the following is appropriate?
1) Changing to Ortho-Novum 1/35
2) Discontinue use
3) Providing reassurance
4) Double dose-for two days - correct answer-3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a
current recommendation guideline for preventive care in elderly female patients?
1) Mammogram and clinical breast exams
2) Fecal Occult blood test and/or sig
3) Rubella serology or vaccination history
4) Pnuemo and influenza vaccines - correct answer-3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, RA10. The best act
ion is to:
1) initiate passive warming
2) apply a rebreather
3) Perform fluid replacement
4) initiate active warming - correct answer-1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would you ed
ucate this patient on recognizing the signs and symptoms of hypoglycemia?
,1) Edema
2) Tachycardia
3) palpitations
4) sweating - correct answer-4) sweating
A 65-year-
old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs, stretching, ice, an
d rest has proven ineffective after 3 weeks. The best follow-up plan of care would be to:
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
2) continue NSAID, apply an arch support and encourage wt loss and exercise
3) continue NSAID, xray and add a short-leg night splint
4) COntinue NSAID, xray and add a metatarsal bar - correct answer-
2) continue NSAID, apply an arch support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
1) nicking of arteriols and viens, and small retinol hemorrages
2) drusen bodies and pale retina
3) pale macula and swollen disk margins
4) microaneurysms and optic disc cupping - correct answer-
1) nicking of arteriols and viens, and small retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
3) atrial fibrillation
4) abnormal T3 suppression - correct answer-3) atrial fibrillation
A 35-year-
old lawn maintenance worker presents reporting "something in my eye" since the previous day. The ey
, e was rinsed with over-the-
counter eyewash, without relief. The patient denies visual disturbances or drainage. In formulating a pl
an of care, the nurse practitioner would FIRST:
1) send to ophthalmologists
2) florescreen staining
3) test visual field
4) prescribe eyedrops - correct answer-3) test visual field
A 72-year-
old patient presents with dry, itchy eyes. During the course of the physical examination, the nurse pract
itioner notes the presence of a gray band of opacity in the cornea that encircles the iris. The band is 1.
0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
1. corneal abrasion
2. arcus senilis
3. corneal ulcer
4. herpetic infection of the eye - correct answer-2) arcus senilis
A 26-year-
old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and a cough tha
t 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 - correct answer-1) xray (tb-night sweats)
A 44-year-
old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On physical e
xamination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI systolic mur
mur at the apex. Further evaluation would include which of the following?