AANP Exam Questions and Answers
A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which of
the following medications, if being actively consumed, must be immediately
stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)
D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and
belongs to a drug class known as serotonin agonists. When used in
conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
pg. 1
,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
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.
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?
pg. 2
,Incorrect
A.
Insulin aspart 70/30
B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec
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
pg. 3
, 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.
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
pg. 4
A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which of
the following medications, if being actively consumed, must be immediately
stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)
D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and
belongs to a drug class known as serotonin agonists. When used in
conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
pg. 1
,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
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.
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?
pg. 2
,Incorrect
A.
Insulin aspart 70/30
B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec
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
pg. 3
, 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.
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
pg. 4
