AANP Practice Exam American Academy of Nurse Practitioners Practice Test

AANP Practice Exam American Academy of Nurse Practitioners Practice Test These are retired test questions from previous years. They are similar in structure, but should not necessarily be considered similar in difficulty when compared with the actual test. Use only as a guide. There are no rationales with the answers. 1. A nurse practitioner is suturing a simple laceration on an 11 year-old patient. The use of lidocaine with epinephrine is contraindicated in all of the following areas EXCEPT the: a. Scalp b. Nose c. Fingers d. Earlobe 2. A patient who is 28 weeks pregnant reports a single episode of vaginal bleeding. History indicates normal prenatal progress to date and the patient denies pain, vaginal itching, or discharge. Which of the following is the most appropriate intervention to aid in the diagnosis of this case? a. Nitrazine test e. Non-stress test f. Ultrasound g. Bimanual cervical examination 3. A 40 year-old male presents with a 2-week history of rectal pain and itching. He reports a past history of constipation and finding spots of bright red blood on the toilet paper several times per week. Rectal examination reveals a tender, swollen, bluish, ovoid mass. The stool guaiac test is negative. Which of the following actions should the nurse practitioner take? a. Refer the patient to a gastroenterologist for a malignancy workup. h. Schedule a colonoscopy to rule out colon cancer. i. Repeat the guaiac test three times and obtain a complete blood count (CBC). j. Prescribe bulk-forming agents and hydrocortisone suppositories. 4. A 65-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? a. Polymyositis k. Osteoarthritis 2 l. Polymyalgia rheumatic a. Fibromyalgia 5. A patient with type 1 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 an at-home glucose test reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens. This is most likely an example of: a. Insulin resistance m. Insulin allergy n. The Somogyi effect o. Hyperglycemia-induced hypoglycemia 6. A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouth that do not rub off when wiped with a 4x4. The patient should be evaluated for: a. HIV infection p. Myelodyspastic syndrome q. Congenital lymphoproliferative disease r. Non-Hodgkin’s lymphoma 7. A routine laboratory assessment of a 12-year-old patient with a family history of thalassemia and anemia reveals Tanner stage II presentation and Hct=35%. In addition to a complete blood count (CBC), the nurse practitioner should order which of the following? a. Serum folic acid s. Vitamin B12 level t. Hemoglobin electrophoresis u. 24-hour urine creatinine 8. An 88-year-old male presents with concerns about memory loss. He feels good, takes and aspirin daily, and has no chronic diseases. He lives alone, drives his own car, and manages his financial affairs. To evaluate his memory, which of the following tests should the nurse practitioner choose? a. Folstein Mini-Mental State Exam v. Geriatric Depression Scale w. Minnesota Multiphasic Personality Inventory x. Myers-Briggs Test 9. A 50-year-old male presents with a chief complaint of malaise. Further questioning reveals that his primary concern is delayed ejaculation. He is currently taking the following medications: atenolol (Tenormin) 50mg daily, paroxetine (Paxil) 20mg daily, loratidine (Claritin-D) 1 tablet daily, and hydrochlorothiazide (HCTZ) 25mg daily. The most likely cause of the patient’s concern would be” a. Loratidine (Claritin-D) 3 y. Hydrochlorothiazide (HCTZ) z. Atenolol (Tenormin) aa. Paroxetine (Paxil) 10. After a 3-week camping trip, an 11-year-old is seen for a target lesion with central clearing, located in the inguinal area. The patient has had a severe headache, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes: a. Trimethoprim-sulfamethoxazole (Bactrim) bb. Azithromycin (Zithromax) cc. Metronidazole (Flagyl) dd. Doxycycline (Doryx) 11. A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated by movement. The patient reports that he participated in extensive house painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness of ecchymosis is present. What is the next step that should be taken in order to make a diagnosis? a. Palpate structures around the shoulder ee. Obtain an MRI to evaluate the shoulder ff. Order an X-ray of the shoulder gg. Request and EMG 12. A nurse practitioner is evaluating a 40-year-old patient suspected of having a pulmonary embolus. The patient complains of anxiety and cough. A stat chest x-ray is normal. Which of the following tests should the nurse practitioner preform next? a. Spirometry hh. Magnetic resonance imagining (MRI) ii. Contrast venography jj. Helical CT pulmonary angiography 13. A nurse practitioner orders pulmonary rehabilitation for a 75-year-old with COPD. Expected outcomes of this program include all of the following EXCEPT: a. Enhanced quality of life kk. Increased lung capacity ll. Decreased in-patient hospitalizations mm. Improved exercise capacity 14. Research findings have shown that , in order to improve the longevity of a patient who has COPD, the treatment choice is: a. Oxygen 4 nn. Anticholinergic drugs oo. Systemic steroids pp. Exercise 15. Which of the following is the most serious outcome of Barrett’s esophagus? a. Esophageal adenocarcinoma qq. Gastroesophageal reflex rr. Peptic stricture ss. Esophageal varices 16. A 39-year-old patient was diagnosed with acute bronchitis in the emergency department and treated with acetaminophen, dextromethorphan, and metaproterenol (Alupent). The patient’s history reveals a smoking habit of 1 pack per day. The patient now presents to a nurse practitioner’s office with a fever of 101.2°F (39.4°C) and a cough productive of thick, yellow-green, foul-smelling sputum. The nurse practitioner should encourage smoking cessation and prescribe: a. theophylline tt. A penicillin antibiotic uu. An inhalable corticosteroid vv. A macrolide antibiotic 17. Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis? a. Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, and many white blood cells ww. Squamous epithelial cells with clear cytoplasm and distinct borders, many lactobacillus rods, and occasional white blood cells xx. Organisms about the size of white blood cells with undulating flagellum, occasional lactobacillus rods, and many white blood cells yy. Hyphae and spores, few lactobacillus rods, and occasional white blood cells 18. Which of the following is NOT an indication of preeclampsia? a. Visual disturbances zz. Glucosuria aaa. Edema of face and hands bbb. Headaches 19. Which of the following gastrointestinal changes is associated with normal aging? a. Decreased production of gastric acid ccc. Decreased incidence of gallstones