AANP Actual Exam
AANP Actual Exam, Practice Exam
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Which of the following headaches typically presents with bilateral pain rather than unilateral
pain?
A.
Cluster headache
B.
Migraine headache
C.
Temporal arteritis
D.
Tension headache
- Correct Answer :D.
Tension headache
Headaches are one of the most commonly reported symptoms in the adult population. It is
important to know the characteristics associated with each type of headache to help correctly
diagnose the condition. Tension headaches (D) are the most commonly reported headaches in
adults. The usual symptoms include mildly to moderately intense head pain that is bilateral in
nature. The pain is typically described as dull, pressure-like, band-like, or fullness-like. Tension
headaches are not usually pulsating or throbbing in quality and do not cause associated nausea,
vomiting, photophobia, or increased pain with movement. Some patients present with increased
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pericranial muscle tenderness, including tenderness in the myofascial muscles, neck muscles,
and shoulders.
A 50-year-old patient presents to their nurse practitioner after their yearly eye exam with the
ophthalmologist. They tell the nurse practitioner that they were told their vision is 20/200 in
both eyes when they are not wearing their prescribed glasses. They ask what this means. Which
of the following is the most appropriate response?
A.
They are okay to drive short distances without their glasses on
B.
They can see at 200 feet what someone with 20/20 vision can see at 20 feet
C.
They will need surgery in the future to correct their vision
D.
Without their glasses, the patient is considered legally blind
- Correct Answer :D.
Without their glasses, the patient is considered legally blind
Legal blindness is considered vision that is 20/200 or less (D) without corrective eyewear. This
means that they can see at 20 feet what a person with 20/20 vision sees at 200 feet. Depending
on the patient's state of residence, a corrected vision to a certain degree may be required to be
able to operate a motor vehicle.
A 24-year-old woman presents with concerns of increased anxiety, night terrors, and feeling as if
she is hyperaware of her surroundings. Based on her presenting symptoms, which of the
following diagnoses is the most likely?
A.
Generalized anxiety disorder
B.
Major depressive disorder
C.
Post-traumatic stress disorder
D.
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Schizophrenia
- Correct Answer :C.
Post-traumatic stress disorder
According to the the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders,
post-traumatic stress disorder (PTSD) (C) is characterized by a specific set of symptoms that
persist for more than 1 month following exposure to actual or threatened death, serious injury,
or sexual violence. Symptoms may include flashbacks, nightmares, dissociation, avoidance of
people or places that trigger memories of the event, trouble concentrating, hypervigilance,
feeling on-edge, and sleep disturbances. Given the patient's presentation, this is the only
diagnosis listed that would appropriately capture her symptoms. Individual therapy is highly
recommended for those experiencing PTSD. Cognitive behavioral therapy, cognitive processing
therapy , and prolonged exposure are the American Psychiatric Association's most strongly
recommended interventions. Medications may also be considered in the treatment plan.
Selective serotonin reuptake inhibitors are typically the first class of medications used in the
treatment of PTSD, though exceptions may occur based on individual needs and circumstances.
A 6-year-old patient presents to the clinic with his parent, who reports several blister-like lesions
on his child's abdomen. The child reports the lesions are pruritic and intermittently painful.
Physical exam reveals large blisters filled with clear-yellow fluid. Which of the following is the
most likely diagnosis?
A.
Bullous impetigo
B.
Herpes zoster
C.
Nonbullous impetigo
D.
Varicella
- Correct Answer :A.
Bullous impetigo
This patient's clinical presentation is consistent with bullous impetigo (A), which is a superficial
skin infection that most commonly affects children. Bullous impetigo is characterized by large
fluid-filled blisters (bullae) with clear-yellow fluid that most commonly develop on the trunk.
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A 22-year-old man presents to the clinic for a follow-up after starting a low-dose tretinoin (Retin-
A) cream. He states that he has noticed a decrease in blackheads but reports an increase in
pustules along his jawline. Which of the following is the best next step in treatment?
A.
Increase the tretinoin dosage and follow up in 8 weeks
B.
Instruct him to continue the tretinoin and start him on tetracycline
C.
Instruct him to continue the tretinoin cream and start him on oral isotretinoin
D.
Instruct him to stop his tretinoin and start him on doxycycline (Vibramycin)
- Correct Answer :A.
Increase the tretinoin dosage and follow up in 8 weeks
Initial treatment of acne vulgaris consists of topical agents, such as topical retinoids like tretinoin
(Retin-A). Tretinoin cream can cause skin irritation, so it should be started at the lowest dose.
The nurse practitioner may also advise the patient to start the cream every other night to
minimize skin irritation. The goal is to slowly increase to daily use and eventually increase the
dose as the patient tolerates it. Since the patient has seen some improvement, the nurse
practitioner should increase the tretinoin dosage and follow up in 8 weeks (A).
fter the death of her mother, a young adolescent begins fulfilling previous duties held by her
mother, including cooking meals and ensuring her siblings complete their school work. This is an
example of which of the following?
A.
Family systems theory
B.
Health belief model
C.
Lewin change model
D.
Transition care model
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