ANCC AGPCNP FINAL EXAM 2025/2026
QUESTIONS AND CORRECT ANSWERS
The nurse practitioner is completing a health assessment on a 15-year-old
female patient who is in the office for her annual physical. The patient reports
feelings of hopelessness and sadness for several months, no history of suicidal
ideations, and a struggle with anorexia. The patient scores an 11 on Beck's
Depression Inventory. Which antidepressant will the nurse practitioner
prescribe?
a. Sertraline (Zoloft)
b. Lithium carbonate (Eskalith)
c. Bupropion (Wellbutrin)
d. Escitalopram (Lexapro)
d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe
depression and no history of suicidal ideations. Sertraline is not a safe option
for patients younger than 24 years of age because of increased risk of suicidal
ideation. Bupropion is an atypical antidepressant and is not a first-line therapy
for depression. It is contraindicated in patients with anorexia nervosa. Lithium
is indicated for patients with bipolar disorder.
Which initial treatment will the nurse practitioner prescribe to a 23-year-old
,female allergic to sulfa drugs who is diagnosed with acute cystitis?
a. Cephalexin (Keflex) 500 mg BID × 5 days
b. Ciprofloxacin (Cipro) 250 mg BID × 3 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
d. Amoxicillin 500 mg BID × 5 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
Nitrofurantoin can be safely administered to a patient with a sulfa allergy to
treat acute cystitis and is the first line of treatment. Cephalexin and amoxicillin
are beta-lactam antibiotics that can be prescribed for a patient who has an
allergy to sulfa and nitrofurantoin. A fluoroquinolone, such as ciprofloxacin, is
recommended for a patient who is allergic to sulfa and beta-lactam drugs or
has a sulfa allergy and a known resistance to beta-lactam antibiotics.
A 68-year-old patient recently prescribed caridopa-levodopa (Sinemet) tells the
nurse practitioner that he has been bloated and experiencing difficulty with
bowel movements. Which medication will the nurse practitioner consider
incorporating into the treatment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol
d. Polyethylene glycol
,Levodopa, an antiparkinsonian drug, can cause constipation in an older patient.
The first-line treatment for the patient's constipation is osmotic laxatives such
as polyethylene glycol. Senna is a stimulant laxative that is a second-line
treatment for constipation in an older adult. Methylnaltrexone is a peripherally
acting mu-opioid antagonist that acts on the gastrointestinal tract to decrease
opioid- induced constipation. Magnesium-based laxatives (e.g., magnesium
citrate) taken over the long term should be avoided because of the potential of
toxicity.
A patient recently returned from a trip to Africa and is experiencing 10 to 12
loose stools every day. The patient takes metformin every morning and
otherwise is in good health. Which medication will the nurse practitioner
prescribe to treat the diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose
d. Ciprofloxacin in a single dose
The patient most likely has traveler's diarrhea, given the history of a recent
return from another country. The patient's treatment should be based on
functional impact of symptoms and not frequency of symptoms, which is not
indicated in the question. The patient likely has moderate acute traveler's
diarrhea, which can be treated with loperamide as monotherapy or with
adjunctive antibiotic therapy. The patient is taking metformin daily for
diabetes, so risk of precipitating hypoglycemia is lower than with other oral
, antidiabetic agents. Because it can be given in a single dose, ciprofloxacin
would be the appropriate choice for reducing exposure and microbiome
colonization disruption. Levofloxacin and ofloxacin require one to three doses.
Trimethoprim-sulfamethoxazole is a sulfonamide and would be appropriate
treatment for cyclosporiasis but not giardiasis, which is the most common
parasitic cause of traveler's diarrhea.
A patient newly diagnosed with diabetes reports severe hives and swollen lips
after taking Bactrim for a bladder infection 2 months ago. Which of the
following statements is correct?
a. The patient cannot take any pills in the sulfonylurea class
b. The patient can take some of the pills in the sulfonylurea class
c. The patient can take any of the pills in the sulfonylurea class
d. None of the above
c. The patient can take any of the pills in the sulfonylurea class
The patient can take any of the pills in the sulfonylurea class.
Available evidence does not support existence of cross-reactivity between the
sulfonamide antimicrobials (e.g., sulfamethoxazole) and the nonantimicrobial
sulfonamides (e.g., furosemide, thiazide diuretics, sulfonylurea
hypoglycemics, protease inhibitors, and carbonic anhydrase inhibitors). This is
due to the differences in their sulfa metabolites. The exception is sulfasalazine,
a disease- modifying antirheumatic drug (DMARD), which can cause a cross-
reaction.
QUESTIONS AND CORRECT ANSWERS
The nurse practitioner is completing a health assessment on a 15-year-old
female patient who is in the office for her annual physical. The patient reports
feelings of hopelessness and sadness for several months, no history of suicidal
ideations, and a struggle with anorexia. The patient scores an 11 on Beck's
Depression Inventory. Which antidepressant will the nurse practitioner
prescribe?
a. Sertraline (Zoloft)
b. Lithium carbonate (Eskalith)
c. Bupropion (Wellbutrin)
d. Escitalopram (Lexapro)
d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe
depression and no history of suicidal ideations. Sertraline is not a safe option
for patients younger than 24 years of age because of increased risk of suicidal
ideation. Bupropion is an atypical antidepressant and is not a first-line therapy
for depression. It is contraindicated in patients with anorexia nervosa. Lithium
is indicated for patients with bipolar disorder.
Which initial treatment will the nurse practitioner prescribe to a 23-year-old
,female allergic to sulfa drugs who is diagnosed with acute cystitis?
a. Cephalexin (Keflex) 500 mg BID × 5 days
b. Ciprofloxacin (Cipro) 250 mg BID × 3 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
d. Amoxicillin 500 mg BID × 5 days
c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days
Nitrofurantoin can be safely administered to a patient with a sulfa allergy to
treat acute cystitis and is the first line of treatment. Cephalexin and amoxicillin
are beta-lactam antibiotics that can be prescribed for a patient who has an
allergy to sulfa and nitrofurantoin. A fluoroquinolone, such as ciprofloxacin, is
recommended for a patient who is allergic to sulfa and beta-lactam drugs or
has a sulfa allergy and a known resistance to beta-lactam antibiotics.
A 68-year-old patient recently prescribed caridopa-levodopa (Sinemet) tells the
nurse practitioner that he has been bloated and experiencing difficulty with
bowel movements. Which medication will the nurse practitioner consider
incorporating into the treatment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol
d. Polyethylene glycol
,Levodopa, an antiparkinsonian drug, can cause constipation in an older patient.
The first-line treatment for the patient's constipation is osmotic laxatives such
as polyethylene glycol. Senna is a stimulant laxative that is a second-line
treatment for constipation in an older adult. Methylnaltrexone is a peripherally
acting mu-opioid antagonist that acts on the gastrointestinal tract to decrease
opioid- induced constipation. Magnesium-based laxatives (e.g., magnesium
citrate) taken over the long term should be avoided because of the potential of
toxicity.
A patient recently returned from a trip to Africa and is experiencing 10 to 12
loose stools every day. The patient takes metformin every morning and
otherwise is in good health. Which medication will the nurse practitioner
prescribe to treat the diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose
d. Ciprofloxacin in a single dose
The patient most likely has traveler's diarrhea, given the history of a recent
return from another country. The patient's treatment should be based on
functional impact of symptoms and not frequency of symptoms, which is not
indicated in the question. The patient likely has moderate acute traveler's
diarrhea, which can be treated with loperamide as monotherapy or with
adjunctive antibiotic therapy. The patient is taking metformin daily for
diabetes, so risk of precipitating hypoglycemia is lower than with other oral
, antidiabetic agents. Because it can be given in a single dose, ciprofloxacin
would be the appropriate choice for reducing exposure and microbiome
colonization disruption. Levofloxacin and ofloxacin require one to three doses.
Trimethoprim-sulfamethoxazole is a sulfonamide and would be appropriate
treatment for cyclosporiasis but not giardiasis, which is the most common
parasitic cause of traveler's diarrhea.
A patient newly diagnosed with diabetes reports severe hives and swollen lips
after taking Bactrim for a bladder infection 2 months ago. Which of the
following statements is correct?
a. The patient cannot take any pills in the sulfonylurea class
b. The patient can take some of the pills in the sulfonylurea class
c. The patient can take any of the pills in the sulfonylurea class
d. None of the above
c. The patient can take any of the pills in the sulfonylurea class
The patient can take any of the pills in the sulfonylurea class.
Available evidence does not support existence of cross-reactivity between the
sulfonamide antimicrobials (e.g., sulfamethoxazole) and the nonantimicrobial
sulfonamides (e.g., furosemide, thiazide diuretics, sulfonylurea
hypoglycemics, protease inhibitors, and carbonic anhydrase inhibitors). This is
due to the differences in their sulfa metabolites. The exception is sulfasalazine,
a disease- modifying antirheumatic drug (DMARD), which can cause a cross-
reaction.
