AANP Practice Questions
1. A 12-year-old with sickle cell anemia has recently experienced a sickle cell crisis
and presents for a follow-up examination after a recent hospitalization. It is most
important to continue monitoring growth, development, and:
1. white blood cell levels.
2. fecal occult blood test.
3. hemoglobin levels.
4. urine dipsticks. - ------------ANS: hemoglobin levels
2. A 13-year-old is concerned because she has not yet begun to menstruate.
Physical examination indicates that the patient is at Tanner stage IV and is of
average height and weight. Which of the following would be the most appropriate
response to this patient?
1. "We'll need to refer you to an endocrinologist for a complete workup."
2. "We'll need to do some tests to find out why you are not having periods."
3. "I'll give you some pills that will make your periods start."
4. "Your development is exactly as expected for your age; you'll probably begin to
have periods within a year." - ------------ANS: "Your development is exactly as
expected for your age; you'll probably begin to have periods within a year."
3. A 16-year-old female adolescent is brought to the nurse practitioner's office by her
mother, who is concerned about her daughter's recent weight loss. History reveals
that the daughter was consistently in the 50th percentile for weight, but is now in the
10th percentile. The mother states that she is concerned that her daughter is purging
herself after meals since she often goes to the restroom after eating and remains
there for a long period of time. The daughter denies any self-induced vomiting,
starvation or excessive activity. She does state that she jogs five miles a day and is
in good condition. In addition to a complete blood count with differential, which of the
following laboratory tests will be most helpful for further assessment?
1. Electrolytes, fasting blood sugar
2. Creatine phosphokinase, follicle-stimulating hormone (FSH)
3. Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis
4. Electrolyte - ------------ANS: electrolytes, blood urea nitrogen (BUN)/creatinine,
urinalysis
4. A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and
omeprazole (Prilosec). The patient complains of headache, abdominal pain, and gas.
These symptoms are most likely:
,1. associated with the omeprazole.
2. related to the underlying condition.
3. the result of the NSAID.
4. caused by viral gastroenteritis. - ------------ANS: associated with the omeprazole
5. A 19-year-old patient who has used oral contraceptives for 3 years plans to
discontinue the pill at the end of her current cycle to become pregnant. Which of the
following daily supplements would receive the highest priority?
1. Calcium carbonate
2. Folic acid
3. Ferrous sulfate
4. Multivitamin - ------------ANS: folic acid
6. A 2-year-old male presents for reevaluation. Two days ago, he had four episodes
of vomiting and six diarrheal stools. On physical examination today, his vital signs
reveal P = 120 and capillary refill of 3 seconds. The patient's eyes are sunken and
his extremities are mottled and cool to the touch. The treatment plan would include:
1. start oral electrolyte mixture every hour.
2. hospitalization for IV fluid replacement.
3. giving the child loperamide for each diarrheal stool.
4. catheterizing the child to obtain accurate urine output. - ------------ANS:
hospitalization for IV fluid replacement
7. A 26-year-old female presents with abdominal distention, bloating, and intermittent
crampy abdominal pain relieved by defecation. She has four to six loose stools a day
when stressed. Between bouts of diarrhea, she often has constipation. Physical
examination results are normal. The CBC was normal. The most likely diagnosis is:
1. diverticulitis.
2. viral gastroenteritis.
3. inflammatory bowel disease.
4. irritable bowel syndrome - ------------ANS: irritable bowel syndrome
8. A 27-year-old male patient, who works as a janitor, presents with a 6-month
history of an intermittent rash on his hands. History reveals itching and occasional
burning. Examination reveals irregularly-distributed scaly maculopapular
erythematous patches extending from the dorsum of the hand several inches up the
forearms, and dry palms with no nail involvement. The most likely diagnosis is:
1. contact dermatitis.
2. scabies infestation.
3. psoriasis.
, 4. eczema. - ------------ANS: contact dermatitis
9. A 28-year-old patient presents with profuse yellow vaginal discharge, odor, and
local irritation. She reports completing a 7-day course of oral metronidazole (Flagyl),
500 mg b.i.d. 4 weeks ago. She has had multiple recurrences over the last 18
months. Microscopic examination reveals presence of clue cells. What is the most
appropriate treatment intervention?
1. Oral metronidazole (Flagyl), 500 mg b.i.d., plus metronidazole vaginal gel
(MetroGel), for 5 days
2. Treat both patient and partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d.,
for 7 days
3. Metronidazole vaginal gel (MetroGel) twice weekly for 4 to 6 months
4. Treat patient with metronidazole vaginal gel (MetroGel) b.i.d. and partner(s) with
tetracycline, 250 mg q.i.d., for 7 days - ------------ANS: Treat both patient and
partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d., for 7 days
10. A 3-year-old female has been diagnosed with bacterial meningitis. She attends
preschool daily at a local church day care program. The day before her diagnosis,
she ate lunch with her mother at a local restaurant. For which contact(s) would
chemoprophylaxis with rifampin be recommended?
1. Preschool contacts in the past 7 days
2. A friend of the patient's sister who visited after school yesterday
3. The checkout employee at the grocery store yesterday
4. Diners at the restaurant during lunch the day the patient ate there - ------------ANS:
preschool contacts in past 7 days
11. A 3-year-old presents with a 2-day history of acute diarrhea with a total of 8
watery stools without blood or mucus, and 2 episodes of vomiting in the past 48
hours. Assessment reveals no current antibiotic therapy, dehydration <5%, soft
abdomen with hyperactive bowel sounds, no masses or organomegaly; other
physical findings are normal. Which of the following is the most appropriate
management plan?
1. Stool culture; Immodium AD liquid.
2. No laboratory workup; instruct parents on signs and symptoms of dehydration; diet
of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup.
3. Start diet of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup over
next 72 hours; Imodium AD liquid, 1 mg/sml
4. Stool for ova and parasites; advise parents of likely sources of Giardia; prescribe
furazolidone (Furoxone) - ------------ANS: No laboratory workup; instruct parents on
signs and symptoms of dehydration; diet of clear liquids, advancing to bananas, rice
cereal, Jell-O, and soup.
1. A 12-year-old with sickle cell anemia has recently experienced a sickle cell crisis
and presents for a follow-up examination after a recent hospitalization. It is most
important to continue monitoring growth, development, and:
1. white blood cell levels.
2. fecal occult blood test.
3. hemoglobin levels.
4. urine dipsticks. - ------------ANS: hemoglobin levels
2. A 13-year-old is concerned because she has not yet begun to menstruate.
Physical examination indicates that the patient is at Tanner stage IV and is of
average height and weight. Which of the following would be the most appropriate
response to this patient?
1. "We'll need to refer you to an endocrinologist for a complete workup."
2. "We'll need to do some tests to find out why you are not having periods."
3. "I'll give you some pills that will make your periods start."
4. "Your development is exactly as expected for your age; you'll probably begin to
have periods within a year." - ------------ANS: "Your development is exactly as
expected for your age; you'll probably begin to have periods within a year."
3. A 16-year-old female adolescent is brought to the nurse practitioner's office by her
mother, who is concerned about her daughter's recent weight loss. History reveals
that the daughter was consistently in the 50th percentile for weight, but is now in the
10th percentile. The mother states that she is concerned that her daughter is purging
herself after meals since she often goes to the restroom after eating and remains
there for a long period of time. The daughter denies any self-induced vomiting,
starvation or excessive activity. She does state that she jogs five miles a day and is
in good condition. In addition to a complete blood count with differential, which of the
following laboratory tests will be most helpful for further assessment?
1. Electrolytes, fasting blood sugar
2. Creatine phosphokinase, follicle-stimulating hormone (FSH)
3. Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis
4. Electrolyte - ------------ANS: electrolytes, blood urea nitrogen (BUN)/creatinine,
urinalysis
4. A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and
omeprazole (Prilosec). The patient complains of headache, abdominal pain, and gas.
These symptoms are most likely:
,1. associated with the omeprazole.
2. related to the underlying condition.
3. the result of the NSAID.
4. caused by viral gastroenteritis. - ------------ANS: associated with the omeprazole
5. A 19-year-old patient who has used oral contraceptives for 3 years plans to
discontinue the pill at the end of her current cycle to become pregnant. Which of the
following daily supplements would receive the highest priority?
1. Calcium carbonate
2. Folic acid
3. Ferrous sulfate
4. Multivitamin - ------------ANS: folic acid
6. A 2-year-old male presents for reevaluation. Two days ago, he had four episodes
of vomiting and six diarrheal stools. On physical examination today, his vital signs
reveal P = 120 and capillary refill of 3 seconds. The patient's eyes are sunken and
his extremities are mottled and cool to the touch. The treatment plan would include:
1. start oral electrolyte mixture every hour.
2. hospitalization for IV fluid replacement.
3. giving the child loperamide for each diarrheal stool.
4. catheterizing the child to obtain accurate urine output. - ------------ANS:
hospitalization for IV fluid replacement
7. A 26-year-old female presents with abdominal distention, bloating, and intermittent
crampy abdominal pain relieved by defecation. She has four to six loose stools a day
when stressed. Between bouts of diarrhea, she often has constipation. Physical
examination results are normal. The CBC was normal. The most likely diagnosis is:
1. diverticulitis.
2. viral gastroenteritis.
3. inflammatory bowel disease.
4. irritable bowel syndrome - ------------ANS: irritable bowel syndrome
8. A 27-year-old male patient, who works as a janitor, presents with a 6-month
history of an intermittent rash on his hands. History reveals itching and occasional
burning. Examination reveals irregularly-distributed scaly maculopapular
erythematous patches extending from the dorsum of the hand several inches up the
forearms, and dry palms with no nail involvement. The most likely diagnosis is:
1. contact dermatitis.
2. scabies infestation.
3. psoriasis.
, 4. eczema. - ------------ANS: contact dermatitis
9. A 28-year-old patient presents with profuse yellow vaginal discharge, odor, and
local irritation. She reports completing a 7-day course of oral metronidazole (Flagyl),
500 mg b.i.d. 4 weeks ago. She has had multiple recurrences over the last 18
months. Microscopic examination reveals presence of clue cells. What is the most
appropriate treatment intervention?
1. Oral metronidazole (Flagyl), 500 mg b.i.d., plus metronidazole vaginal gel
(MetroGel), for 5 days
2. Treat both patient and partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d.,
for 7 days
3. Metronidazole vaginal gel (MetroGel) twice weekly for 4 to 6 months
4. Treat patient with metronidazole vaginal gel (MetroGel) b.i.d. and partner(s) with
tetracycline, 250 mg q.i.d., for 7 days - ------------ANS: Treat both patient and
partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d., for 7 days
10. A 3-year-old female has been diagnosed with bacterial meningitis. She attends
preschool daily at a local church day care program. The day before her diagnosis,
she ate lunch with her mother at a local restaurant. For which contact(s) would
chemoprophylaxis with rifampin be recommended?
1. Preschool contacts in the past 7 days
2. A friend of the patient's sister who visited after school yesterday
3. The checkout employee at the grocery store yesterday
4. Diners at the restaurant during lunch the day the patient ate there - ------------ANS:
preschool contacts in past 7 days
11. A 3-year-old presents with a 2-day history of acute diarrhea with a total of 8
watery stools without blood or mucus, and 2 episodes of vomiting in the past 48
hours. Assessment reveals no current antibiotic therapy, dehydration <5%, soft
abdomen with hyperactive bowel sounds, no masses or organomegaly; other
physical findings are normal. Which of the following is the most appropriate
management plan?
1. Stool culture; Immodium AD liquid.
2. No laboratory workup; instruct parents on signs and symptoms of dehydration; diet
of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup.
3. Start diet of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup over
next 72 hours; Imodium AD liquid, 1 mg/sml
4. Stool for ova and parasites; advise parents of likely sources of Giardia; prescribe
furazolidone (Furoxone) - ------------ANS: No laboratory workup; instruct parents on
signs and symptoms of dehydration; diet of clear liquids, advancing to bananas, rice
cereal, Jell-O, and soup.
