AANP AGPCNP PSI TEST 1 AND 2 PRACTICE
SOLUTION 2026 TESTED QUESTIONS WITH
FULL ANSWERS
◉ S2. Answer: Dub/Diastole - Closure of SL Valves (aortic and
pulmonic)
◉ Split S2. Answer: Normal if heard during inspiration, abnormal if
heard during inspiration AND expiration
◉ S3. Answer: Gallop/Extra fluid, commonly heard in pregnancy,
sounds like Kentucky
◉ S4. Answer: Atrial Kick, seen in uncontrolled HTN, LV
hypertrophy, and in the elderly (benign), sounds like Tennessee
◉ Mitral Regurgitation. Answer: Systolic murmur that radiates to
axilla
◉ Aortic Stenosis. Answer: Systolic murmur that radiates to neck
◉ Mitral Valve Prolapse. Answer: Systolic murmur heard with a
'click'
,◉ Mitral Stenosis. Answer: Diastolic murmur that needs to be
referred
◉ Aortic Regurgitation. Answer: Diastolic murmur that needs to be
referred
◉ AHA/ACC. Answer: Goal BP <130/80, initiate BP meds if ASCVD is
>10%
◉ JNC-8. Answer: Goal BP <140/90, <150/90 if >60y, <140/90 if
<60y with CKD or DM
◉ ACE-Inhibitors. Answer: End in '-pril', cardioprotective for HTN
patients, renal protective for DM patients, avoid in those with CHF
◉ ARBs. Answer: End in '-sartan', cardioprotective for HTN patients,
renal protective for DM patients, avoid in those with CHF
◉ Thiazide Diuretics. Answer: Preferred for those with osteoporosis,
increase triglycerides, uric acid, and glucose, not for those with Gout,
DM, and Cholesterolemia, not for GFR <30
,◉ Calcium Channel Blockers (CCB). Answer: End in '-pine', preferred
in patients >65yrs with stiff arteries, avoid in GERD patients, not for
HF patients
◉ Lipid Profile. Answer: Total Cholesterol <200, HDL 40-60, LDL
<100, Triglycerides <150
◉ High Intensity Statins. Answer: Consider if LDL >190 with co-
morbidities or if >65yrs, e.g., Rosuvastatin (Crestor) 20-40MG/D,
Atorvastatin (Lipitor) 40-80MG/D, avoid grapefruit with statins
◉ Pulsus Paradoxus. Answer: A >10-point drop in systolic BP
between breaths, concern in Status Asthmaticus and Cardiac
Tamponade
◉ AFib. Answer: No P wave with irregular heart rate, controlled Afib
(HR <100), uncontrolled Afib (HR >100)
◉ Amiodarone. Answer: Rhythm control medication for AFib, assess
CXR and pulmonary function test prior to initiation, long term use
can lead to hypothyroidism, pulmonary toxicity, corneal deposits ->
optic neuropathy
, ◉ Warfarin. Answer: Normal INR: 2-3, INR <2 increase dose,
antidote: Vitamin K, INR<9- Hold & drop dose, INR >10 without
bleeding- PO vitamin K, INR>10 WITH bleeding- IV Vitamin K
◉ Trigeminal Neuralgia. Answer: Sever, stabbing pain on side of the
face; treated with Tegretol (Carbamazepine); watch for suicidal
ideation
◉ Bell's Palsy. Answer: Unilateral facial droop and drooling;
common in pregnancy, HSV, and DM; treated with Steroids
(Prednisone); watch for corneal abrasion
◉ Migraines. Answer: Unilateral with or without aura; symptoms
include photophobia, phonophobia, nausea, vomiting, and pulsating;
treated with NSAIDs and Triptans; prophylactic treatment involves
avoiding triggers and medications like Timolol, Topiramate,
Depakote, Amitriptyline, and Propranolol
◉ Cluster Headache. Answer: Unilateral headaches lasting 15
minutes to 3+ hours; common in men 30+ years; symptoms include
eye or temporal pain, tearing or runny nose on affected side;
prophylactic treatment with Verapamil and during attacks use high
flow O2 and Sumatriptan (Imitrex)
SOLUTION 2026 TESTED QUESTIONS WITH
FULL ANSWERS
◉ S2. Answer: Dub/Diastole - Closure of SL Valves (aortic and
pulmonic)
◉ Split S2. Answer: Normal if heard during inspiration, abnormal if
heard during inspiration AND expiration
◉ S3. Answer: Gallop/Extra fluid, commonly heard in pregnancy,
sounds like Kentucky
◉ S4. Answer: Atrial Kick, seen in uncontrolled HTN, LV
hypertrophy, and in the elderly (benign), sounds like Tennessee
◉ Mitral Regurgitation. Answer: Systolic murmur that radiates to
axilla
◉ Aortic Stenosis. Answer: Systolic murmur that radiates to neck
◉ Mitral Valve Prolapse. Answer: Systolic murmur heard with a
'click'
,◉ Mitral Stenosis. Answer: Diastolic murmur that needs to be
referred
◉ Aortic Regurgitation. Answer: Diastolic murmur that needs to be
referred
◉ AHA/ACC. Answer: Goal BP <130/80, initiate BP meds if ASCVD is
>10%
◉ JNC-8. Answer: Goal BP <140/90, <150/90 if >60y, <140/90 if
<60y with CKD or DM
◉ ACE-Inhibitors. Answer: End in '-pril', cardioprotective for HTN
patients, renal protective for DM patients, avoid in those with CHF
◉ ARBs. Answer: End in '-sartan', cardioprotective for HTN patients,
renal protective for DM patients, avoid in those with CHF
◉ Thiazide Diuretics. Answer: Preferred for those with osteoporosis,
increase triglycerides, uric acid, and glucose, not for those with Gout,
DM, and Cholesterolemia, not for GFR <30
,◉ Calcium Channel Blockers (CCB). Answer: End in '-pine', preferred
in patients >65yrs with stiff arteries, avoid in GERD patients, not for
HF patients
◉ Lipid Profile. Answer: Total Cholesterol <200, HDL 40-60, LDL
<100, Triglycerides <150
◉ High Intensity Statins. Answer: Consider if LDL >190 with co-
morbidities or if >65yrs, e.g., Rosuvastatin (Crestor) 20-40MG/D,
Atorvastatin (Lipitor) 40-80MG/D, avoid grapefruit with statins
◉ Pulsus Paradoxus. Answer: A >10-point drop in systolic BP
between breaths, concern in Status Asthmaticus and Cardiac
Tamponade
◉ AFib. Answer: No P wave with irregular heart rate, controlled Afib
(HR <100), uncontrolled Afib (HR >100)
◉ Amiodarone. Answer: Rhythm control medication for AFib, assess
CXR and pulmonary function test prior to initiation, long term use
can lead to hypothyroidism, pulmonary toxicity, corneal deposits ->
optic neuropathy
, ◉ Warfarin. Answer: Normal INR: 2-3, INR <2 increase dose,
antidote: Vitamin K, INR<9- Hold & drop dose, INR >10 without
bleeding- PO vitamin K, INR>10 WITH bleeding- IV Vitamin K
◉ Trigeminal Neuralgia. Answer: Sever, stabbing pain on side of the
face; treated with Tegretol (Carbamazepine); watch for suicidal
ideation
◉ Bell's Palsy. Answer: Unilateral facial droop and drooling;
common in pregnancy, HSV, and DM; treated with Steroids
(Prednisone); watch for corneal abrasion
◉ Migraines. Answer: Unilateral with or without aura; symptoms
include photophobia, phonophobia, nausea, vomiting, and pulsating;
treated with NSAIDs and Triptans; prophylactic treatment involves
avoiding triggers and medications like Timolol, Topiramate,
Depakote, Amitriptyline, and Propranolol
◉ Cluster Headache. Answer: Unilateral headaches lasting 15
minutes to 3+ hours; common in men 30+ years; symptoms include
eye or temporal pain, tearing or runny nose on affected side;
prophylactic treatment with Verapamil and during attacks use high
flow O2 and Sumatriptan (Imitrex)
