AANP Review Final Exam Practice
Questions and Answers Verified Solutions
Latest Update 2026/2027
Question:
Which of the following is not a symptom of both major depressive disorder and post-traumatic
stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty
Answer:
B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive disorder (MDD)
may also include symptoms of depressed mood, anhedonia, weight loss or gain, and low energy.
However, hypervigilance (B) is not a symptom associated with this diagnosis.
Question:
A patient with type 1 diabetes presents for a follow-up visit. He has been stable on his medication
regimen but is worried because he is between jobs and will be without health insurance coverage
for a few months. He asks if there are less expensive insulin options to get him through this time.
Which of the following would be good options for this patient, given his circumstance?
Incorrect
A.
Insulin aspart 70/30
B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec
Answer:
,Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral protamine
Hagedorn insulin). There are also often pharmacy-specific coupons that can be used on insulin, so
helping patients apply for and navigate these programs can be instrumental in managing their
diabetes. Another inexpensive option is regular insulin.Insulin analogs (glargine, detemir,
degludec, lispro, and aspart) are significantly more expensive than human insulin (isophane,
regular). Insulins modified by manufacturers, especially when sold as brand-name medications,
tend to be more expensive due to this modification. While analogs offer alternate lengths of action
and convenience, there is no well-documented clinical evidence that patient outcomes are improved
with differing brands. Therefore, maintaining a patient's blood glucose level through
outcome-focused treatment is more valuable than a process-focused plan based on medication.
Question:
A 40-year-old woman with type 2 diabetes presents to the clinic with concerns of spiking blood
sugar between lunch and dinner. She states she is on a rapid-acting insulin sliding scale and
long-acting insulin. Which change should be implemented to help prevent or curb this glycemic
spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
Answer:
A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals and as a
sliding scale regimen based on a patient's glucose prior to eating (preprandial). It is the appropriate
insulin to add as a mealtime dose when patients experience blood glucose spikes between meals
because of its short-acting properties. Peak time action of insulin aspart is 2 hours with initial effect
within the first 30 minutes,
making it an ideal choice to control expected postprandial glycemic spikes
Question:
Which of the following conditions is associated with an increased risk for conductive hearing loss?
A.
Acoustic neuroma
,B.
Ménière disease
C.
Otitis media
D.
Presbycusis
Answer:
C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects in the ear
canal, impacted ear wax, tumors, congenital anomalies, discontinuity of middle ear bones,
cholesteatoma, and tympanic membrane rupture. Sound normally travels down the ear canal to
vibrate the eardrum (tympanic membrane). The eardrum is connected to three middle ear bones
(malleus, incus, and stapes), which transmit
the sound into the inner ear (cochlea). The cochlea is the organ that changes sound vibrations into a
nerve signal that travels to the brain. The four types of hearing loss are conductive, sensorineural,
mixed, and retrocochlear. Conductive hearing loss occurs when sound cannot effectively reach the
inner ear due to issue in the outer ear and middle ear.
Question:
A 23-year-old patient who is pregnant at 28 weeks gestation presents to the clinic for a routine
prenatal checkup. Which fundal height measurement would warrant a more conclusive assessment
with an ultrasound?
A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm
Answer:
D. 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring tape in
centimeters and should match the gestational age. It can be > or < 2 centimeters and still be within
normal limits. A fundal height of 26-30 cm is a normal finding in a patient who is 28 weeks
gestation. A result of 31 cm (D) is larger than expected and should be further evaluated with an
ultrasound.
, Question:
A 4-year-old boy presents with ear pain and an erythematous, bulging tympanic membrane on
examination. The nurse practitioner diagnoses him with acute otitis media. Which of the following
are the three most common bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
D.
Nontypeable Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae
Answer:
C. Nontypeable Haemophilus influenzae, Moraxella catarrhalis,
Streptococcus pneumoniae
Acute otitis media is commonly encountered by primary care nurse practitioners. Typically,
children present with otalgia and have a bulging tympanic membrane on examination. Many times,
children also have a preceding viral upper respiratory infection, resulting in the colonization of
bacteria in the middle ear and leading to a bacterial infection. Ear infections can be caused by
bacterial and viral pathogens. The most common bacterial pathogens isolated from middle ear fluid
are nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae
(C). The most common viral pathogens include respiratory syncytial virus, coronaviruses, influenza
viruses, and adenoviruses. Treatment for acute otitis media should be targeted to combat the most
common bacterial causes, including amoxicillin (penicillin), amoxicillin-clavulanate (penicillin and
combination beta- lactam and beta-lactamase inhibitor), and an oral second-generation
cephalosporin (e.g., cefuroxime) in the case of a child with a penicillin allergy.
Question:
A 6-year-old patient presents to the clinic accompanied by his mother, who reports concerns
regarding her child's progressive urinary issues. The patient's mother states that she and the child's
father recently divorced, and the child alternates weekly between her house and his father's house.
She reports he experiences episodes of urinary incontinence and holds his stomach as if he is in
pain. He frequently asks to use the bathroom but is scared of urination once he is there. Which of
the following is the most likely diagnosis?
A.
Adjustment disorder
B.
Questions and Answers Verified Solutions
Latest Update 2026/2027
Question:
Which of the following is not a symptom of both major depressive disorder and post-traumatic
stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty
Answer:
B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive disorder (MDD)
may also include symptoms of depressed mood, anhedonia, weight loss or gain, and low energy.
However, hypervigilance (B) is not a symptom associated with this diagnosis.
Question:
A patient with type 1 diabetes presents for a follow-up visit. He has been stable on his medication
regimen but is worried because he is between jobs and will be without health insurance coverage
for a few months. He asks if there are less expensive insulin options to get him through this time.
Which of the following would be good options for this patient, given his circumstance?
Incorrect
A.
Insulin aspart 70/30
B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec
Answer:
,Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral protamine
Hagedorn insulin). There are also often pharmacy-specific coupons that can be used on insulin, so
helping patients apply for and navigate these programs can be instrumental in managing their
diabetes. Another inexpensive option is regular insulin.Insulin analogs (glargine, detemir,
degludec, lispro, and aspart) are significantly more expensive than human insulin (isophane,
regular). Insulins modified by manufacturers, especially when sold as brand-name medications,
tend to be more expensive due to this modification. While analogs offer alternate lengths of action
and convenience, there is no well-documented clinical evidence that patient outcomes are improved
with differing brands. Therefore, maintaining a patient's blood glucose level through
outcome-focused treatment is more valuable than a process-focused plan based on medication.
Question:
A 40-year-old woman with type 2 diabetes presents to the clinic with concerns of spiking blood
sugar between lunch and dinner. She states she is on a rapid-acting insulin sliding scale and
long-acting insulin. Which change should be implemented to help prevent or curb this glycemic
spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
Answer:
A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals and as a
sliding scale regimen based on a patient's glucose prior to eating (preprandial). It is the appropriate
insulin to add as a mealtime dose when patients experience blood glucose spikes between meals
because of its short-acting properties. Peak time action of insulin aspart is 2 hours with initial effect
within the first 30 minutes,
making it an ideal choice to control expected postprandial glycemic spikes
Question:
Which of the following conditions is associated with an increased risk for conductive hearing loss?
A.
Acoustic neuroma
,B.
Ménière disease
C.
Otitis media
D.
Presbycusis
Answer:
C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects in the ear
canal, impacted ear wax, tumors, congenital anomalies, discontinuity of middle ear bones,
cholesteatoma, and tympanic membrane rupture. Sound normally travels down the ear canal to
vibrate the eardrum (tympanic membrane). The eardrum is connected to three middle ear bones
(malleus, incus, and stapes), which transmit
the sound into the inner ear (cochlea). The cochlea is the organ that changes sound vibrations into a
nerve signal that travels to the brain. The four types of hearing loss are conductive, sensorineural,
mixed, and retrocochlear. Conductive hearing loss occurs when sound cannot effectively reach the
inner ear due to issue in the outer ear and middle ear.
Question:
A 23-year-old patient who is pregnant at 28 weeks gestation presents to the clinic for a routine
prenatal checkup. Which fundal height measurement would warrant a more conclusive assessment
with an ultrasound?
A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm
Answer:
D. 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring tape in
centimeters and should match the gestational age. It can be > or < 2 centimeters and still be within
normal limits. A fundal height of 26-30 cm is a normal finding in a patient who is 28 weeks
gestation. A result of 31 cm (D) is larger than expected and should be further evaluated with an
ultrasound.
, Question:
A 4-year-old boy presents with ear pain and an erythematous, bulging tympanic membrane on
examination. The nurse practitioner diagnoses him with acute otitis media. Which of the following
are the three most common bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae
D.
Nontypeable Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae
Answer:
C. Nontypeable Haemophilus influenzae, Moraxella catarrhalis,
Streptococcus pneumoniae
Acute otitis media is commonly encountered by primary care nurse practitioners. Typically,
children present with otalgia and have a bulging tympanic membrane on examination. Many times,
children also have a preceding viral upper respiratory infection, resulting in the colonization of
bacteria in the middle ear and leading to a bacterial infection. Ear infections can be caused by
bacterial and viral pathogens. The most common bacterial pathogens isolated from middle ear fluid
are nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae
(C). The most common viral pathogens include respiratory syncytial virus, coronaviruses, influenza
viruses, and adenoviruses. Treatment for acute otitis media should be targeted to combat the most
common bacterial causes, including amoxicillin (penicillin), amoxicillin-clavulanate (penicillin and
combination beta- lactam and beta-lactamase inhibitor), and an oral second-generation
cephalosporin (e.g., cefuroxime) in the case of a child with a penicillin allergy.
Question:
A 6-year-old patient presents to the clinic accompanied by his mother, who reports concerns
regarding her child's progressive urinary issues. The patient's mother states that she and the child's
father recently divorced, and the child alternates weekly between her house and his father's house.
She reports he experiences episodes of urinary incontinence and holds his stomach as if he is in
pain. He frequently asks to use the bathroom but is scared of urination once he is there. Which of
the following is the most likely diagnosis?
A.
Adjustment disorder
B.
