AANP AGPCNP PSI Test 1 & 2 - Practice Exam Bank
Total Questions: 100
QUESTION 1
An 88-year-old presents with right-side weakness after being unable to rise unassisted
following a fall to the bathroom floor. History includes aphasia and noncompliance with
hypertension medication regimen. What is the most likely diagnosis?
A) Right-sided Cerebrovascular Accident (CVA)
B) Left-sided Cerebrovascular Accident (CVA)
C) Transient Ischemic Attack (TIA)
D) Subarachnoid Hemorrhage
ANSWER: B
RATIONALE: A left-sided CVA (stroke) in the brain typically causes right-sided weakness
(hemiparesis) because the motor pathways cross over. This presentation, combined with
aphasia (often from left hemisphere damage) and a history of uncontrolled hypertension,
is highly suggestive of a left-sided CVA .
QUESTION 2
Which of the following signs/symptoms are often associated with headaches due to an
intracranial tumor?
A) Acute onset: hours to days
B) Pain worse when laying down, focal neurological signs
C) Hyperflexia, personality change
D) Pupillary constriction; stupor
ANSWER: B
RATIONALE: Headaches from an intracranial mass or tumor are often characterized by
pain that worsens when lying down (due to increased intracranial pressure) and are
frequently accompanied by focal neurological deficits, depending on the tumor's location
.
,QUESTION 3
Which of the following pharmacotherapeutics would be most important to administer to
a patient who has a corneal abrasion?
A) Timolol
B) Gentamicin ophthalmic
C) Cromolyn ophthalmic
D) Olopatadine
ANSWER: B
RATIONALE: Gentamicin ophthalmic solution (or another topical antibiotic) is a
cornerstone of treatment for a corneal abrasion. It is used to prevent a secondary
bacterial infection, which is a serious complication that can lead to corneal ulceration
and vision loss .
QUESTION 4
A 25-year-old presents with the chief complaint of decreased mobility and pain of the
right shoulder exacerbated by movement. The patient reports he participated in
extensive house painting 24 hours prior to the onset of pain. He denies any trauma.
Passive ROM is intact. No redness or ecchymosis is present. What is the next step to be
taken in order to make a diagnosis?
A) X-ray of shoulder
B) Palpate structures around the shoulder.
C) MRI of shoulder
D) EMG
ANSWER: B
RATIONALE: This presentation is classic for a rotator cuff strain or tendinopathy from
overuse. A focused physical examination, including palpation of the shoulder structures
(biceps tendon, supraspinatus) and specific special tests, is the most appropriate next
step before ordering advanced imaging .
QUESTION 5
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of
midcycle spotting. She has not missed any doses and uses no other medication. Which
of the following is appropriate?
A) Changing to Ortho-Novum 1/35
B) Discontinue use
, C) Providing reassurance
D) Double dose for two days
ANSWER: C
RATIONALE: Breakthrough bleeding (midcycle spotting) is a common and expected side
effect during the first 1-3 months of initiating combined oral contraceptives as the
endometrium adjusts to the hormones. As long as the patient is compliant, reassurance
is the appropriate management .
QUESTION 6
According to the Report of the U.S. Preventive Services Task Force, which of the
following is NOT a current recommendation guideline for preventive care in elderly
female patients?
A) Mammogram and clinical breast exams
B) Fecal Occult blood test and/or sigmoidoscopy
C) Rubella serology or vaccination history
D) Pneumococcal and influenza vaccines
ANSWER: C
RATIONALE: Rubella serology and vaccination history are part of routine prenatal and
preconception care, not a standard USPSTF recommendation for general preventive care
in all elderly female patients. Mammograms, colorectal cancer screening, and
immunizations (pneumococcal and influenza) are core components of geriatric
preventive care .
QUESTION 7
An 87 y/o nursing home patient is drowsy and barely responsive. Temp 95°F, BP:
110/70, Pulse 60, R 10. The best action is to:
A) Initiate passive warming
B) Apply a rebreather mask
C) Perform fluid replacement
D) Initiate active warming
ANSWER: A
RATIONALE: This patient is presenting with hypothermia. The treatment of choice for a
stable patient with mild to moderate hypothermia is passive rewarming (removing wet
clothing, covering with warm blankets, raising room temperature). Active rewarming
Total Questions: 100
QUESTION 1
An 88-year-old presents with right-side weakness after being unable to rise unassisted
following a fall to the bathroom floor. History includes aphasia and noncompliance with
hypertension medication regimen. What is the most likely diagnosis?
A) Right-sided Cerebrovascular Accident (CVA)
B) Left-sided Cerebrovascular Accident (CVA)
C) Transient Ischemic Attack (TIA)
D) Subarachnoid Hemorrhage
ANSWER: B
RATIONALE: A left-sided CVA (stroke) in the brain typically causes right-sided weakness
(hemiparesis) because the motor pathways cross over. This presentation, combined with
aphasia (often from left hemisphere damage) and a history of uncontrolled hypertension,
is highly suggestive of a left-sided CVA .
QUESTION 2
Which of the following signs/symptoms are often associated with headaches due to an
intracranial tumor?
A) Acute onset: hours to days
B) Pain worse when laying down, focal neurological signs
C) Hyperflexia, personality change
D) Pupillary constriction; stupor
ANSWER: B
RATIONALE: Headaches from an intracranial mass or tumor are often characterized by
pain that worsens when lying down (due to increased intracranial pressure) and are
frequently accompanied by focal neurological deficits, depending on the tumor's location
.
,QUESTION 3
Which of the following pharmacotherapeutics would be most important to administer to
a patient who has a corneal abrasion?
A) Timolol
B) Gentamicin ophthalmic
C) Cromolyn ophthalmic
D) Olopatadine
ANSWER: B
RATIONALE: Gentamicin ophthalmic solution (or another topical antibiotic) is a
cornerstone of treatment for a corneal abrasion. It is used to prevent a secondary
bacterial infection, which is a serious complication that can lead to corneal ulceration
and vision loss .
QUESTION 4
A 25-year-old presents with the chief complaint of decreased mobility and pain of the
right shoulder exacerbated by movement. The patient reports he participated in
extensive house painting 24 hours prior to the onset of pain. He denies any trauma.
Passive ROM is intact. No redness or ecchymosis is present. What is the next step to be
taken in order to make a diagnosis?
A) X-ray of shoulder
B) Palpate structures around the shoulder.
C) MRI of shoulder
D) EMG
ANSWER: B
RATIONALE: This presentation is classic for a rotator cuff strain or tendinopathy from
overuse. A focused physical examination, including palpation of the shoulder structures
(biceps tendon, supraspinatus) and specific special tests, is the most appropriate next
step before ordering advanced imaging .
QUESTION 5
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of
midcycle spotting. She has not missed any doses and uses no other medication. Which
of the following is appropriate?
A) Changing to Ortho-Novum 1/35
B) Discontinue use
, C) Providing reassurance
D) Double dose for two days
ANSWER: C
RATIONALE: Breakthrough bleeding (midcycle spotting) is a common and expected side
effect during the first 1-3 months of initiating combined oral contraceptives as the
endometrium adjusts to the hormones. As long as the patient is compliant, reassurance
is the appropriate management .
QUESTION 6
According to the Report of the U.S. Preventive Services Task Force, which of the
following is NOT a current recommendation guideline for preventive care in elderly
female patients?
A) Mammogram and clinical breast exams
B) Fecal Occult blood test and/or sigmoidoscopy
C) Rubella serology or vaccination history
D) Pneumococcal and influenza vaccines
ANSWER: C
RATIONALE: Rubella serology and vaccination history are part of routine prenatal and
preconception care, not a standard USPSTF recommendation for general preventive care
in all elderly female patients. Mammograms, colorectal cancer screening, and
immunizations (pneumococcal and influenza) are core components of geriatric
preventive care .
QUESTION 7
An 87 y/o nursing home patient is drowsy and barely responsive. Temp 95°F, BP:
110/70, Pulse 60, R 10. The best action is to:
A) Initiate passive warming
B) Apply a rebreather mask
C) Perform fluid replacement
D) Initiate active warming
ANSWER: A
RATIONALE: This patient is presenting with hypothermia. The treatment of choice for a
stable patient with mild to moderate hypothermia is passive rewarming (removing wet
clothing, covering with warm blankets, raising room temperature). Active rewarming
