AANP AGPCNP PSI TEST 1 AND 2 FINAL PAPER
2026 COMPLETE QUESTIONS AND
SOLUTIONS
◉ A 58-year-old female presents with shoulder and pelvic girdle
pain for the past 6 months. She reports recent unintentional weight
loss. On physical examination, there is pain on ROM, with no
weakness noted. Laboratory studies show a low hemoglobin and an
elevated sedimentation rate. Which of the following is the most
likely diagnosis?
1) Polymyalgia rheumatica
2) polymyositis
3) osteoarthritis
4) Fibromyalgia Answer: 1) polymyalgia rheumatica
◉ An 85-year-old male relates that on the way to his annual physical
examination, he suffered a sudden loss of vision in his right eye
characterized by "a bunch of lights" and a feeling that "a curtain
came down." All of the following would be included in the
differential diagnosis EXCEPT:
,1) opthalmolic migraine
2) retinal detachment.
3) diabetic retinopathy.
4) TIA Answer: 3) diabetic retinopathy
◉ A patient with diabetes mellitus who is on NPH and regular
insulin split-dosing presents with complaints of early morning rise
in fingerstick blood glucose. A review of self blood glucose
monitoring reveals increased morning levels. After an increase in the
evening insulin dose, the problem worsens. This is most likely an
example of:
1) insulin resistance
2) the Somogyi effect.
3) needing more insulin in the mornings
4) Need to increase insulin at night Answer: 2) Somogyi effect
◉ In a healthy elder, which of the following TRADITIONALLY defines
a positive urine culture?
1) ≥100,000 colonies/mL of a single organism
2) ≥10,000 colonies/mL of a single organism
,3) ≥100,000 colonies/mL of a two or more organisms Answer:
≥100,000 colonies/mL of a single organism
◉ A 55-year-old patient exhibits a verified serum calcium level of 13
mg/dL [normal = 8.9-10.2 mg/dL]. The next step in determining the
presence of pathology is to order a:
1) BUN and serum creatinine.
2) 24 hour urine
3) parathyroid hormone level.
4) thyroid panel Answer: 3) parathyroid hormone level
◉ An 88-year-old female presents with a 3-day history of vertigo.
The patient has a past medical history of hypertension controlled
with metoprolol, 50 mg daily. She reports that the presenting
symptoms are constant, severe, and accompanied by nausea and
vomiting. She denies experiencing diplopia, slurring of speech, chest
pain, dyspnea, or diaphoresis. She exhibits mild anxiety and
reluctance to change position or turn the head. BP = 126/76; P = 78;
R = 16/min; and T = 98.2°F (36.8°C). HEENT examination reveals 17
beats of horizontal nystagmus on right lateral gaze; the nystagmus
stops after several repetitions of the maneuver. Funduscopic,
cardiac, pulmonary, abdominal, and neurologic examination results
are normal. The most likely diagnosis is:
, 1) acoustic neuroma
2) vestibular neuritis.
3) vertibailar insufficiency
4) TIA Answer: 2) vestibular neuritis
◉ When initiating thyroid hormone replacement in the older adult,
care must be taken to evaluate the patient's:
1) coronary status.
2) weight
3) renal function
4) mental state Answer: 1) coronary status
◉ Which of the following would be most appropriate to perform in
the initial evaluation of a patient with symptoms of acute prostatitis?
1) Prostate-specific antigen (PSA)
2) Urinalysis and urine culture
3) Scrotal massage and urine sample
2026 COMPLETE QUESTIONS AND
SOLUTIONS
◉ A 58-year-old female presents with shoulder and pelvic girdle
pain for the past 6 months. She reports recent unintentional weight
loss. On physical examination, there is pain on ROM, with no
weakness noted. Laboratory studies show a low hemoglobin and an
elevated sedimentation rate. Which of the following is the most
likely diagnosis?
1) Polymyalgia rheumatica
2) polymyositis
3) osteoarthritis
4) Fibromyalgia Answer: 1) polymyalgia rheumatica
◉ An 85-year-old male relates that on the way to his annual physical
examination, he suffered a sudden loss of vision in his right eye
characterized by "a bunch of lights" and a feeling that "a curtain
came down." All of the following would be included in the
differential diagnosis EXCEPT:
,1) opthalmolic migraine
2) retinal detachment.
3) diabetic retinopathy.
4) TIA Answer: 3) diabetic retinopathy
◉ A patient with diabetes mellitus who is on NPH and regular
insulin split-dosing presents with complaints of early morning rise
in fingerstick blood glucose. A review of self blood glucose
monitoring reveals increased morning levels. After an increase in the
evening insulin dose, the problem worsens. This is most likely an
example of:
1) insulin resistance
2) the Somogyi effect.
3) needing more insulin in the mornings
4) Need to increase insulin at night Answer: 2) Somogyi effect
◉ In a healthy elder, which of the following TRADITIONALLY defines
a positive urine culture?
1) ≥100,000 colonies/mL of a single organism
2) ≥10,000 colonies/mL of a single organism
,3) ≥100,000 colonies/mL of a two or more organisms Answer:
≥100,000 colonies/mL of a single organism
◉ A 55-year-old patient exhibits a verified serum calcium level of 13
mg/dL [normal = 8.9-10.2 mg/dL]. The next step in determining the
presence of pathology is to order a:
1) BUN and serum creatinine.
2) 24 hour urine
3) parathyroid hormone level.
4) thyroid panel Answer: 3) parathyroid hormone level
◉ An 88-year-old female presents with a 3-day history of vertigo.
The patient has a past medical history of hypertension controlled
with metoprolol, 50 mg daily. She reports that the presenting
symptoms are constant, severe, and accompanied by nausea and
vomiting. She denies experiencing diplopia, slurring of speech, chest
pain, dyspnea, or diaphoresis. She exhibits mild anxiety and
reluctance to change position or turn the head. BP = 126/76; P = 78;
R = 16/min; and T = 98.2°F (36.8°C). HEENT examination reveals 17
beats of horizontal nystagmus on right lateral gaze; the nystagmus
stops after several repetitions of the maneuver. Funduscopic,
cardiac, pulmonary, abdominal, and neurologic examination results
are normal. The most likely diagnosis is:
, 1) acoustic neuroma
2) vestibular neuritis.
3) vertibailar insufficiency
4) TIA Answer: 2) vestibular neuritis
◉ When initiating thyroid hormone replacement in the older adult,
care must be taken to evaluate the patient's:
1) coronary status.
2) weight
3) renal function
4) mental state Answer: 1) coronary status
◉ Which of the following would be most appropriate to perform in
the initial evaluation of a patient with symptoms of acute prostatitis?
1) Prostate-specific antigen (PSA)
2) Urinalysis and urine culture
3) Scrotal massage and urine sample
