AANP Certification

If your patient is in the catarrhal stage of pertussis, upon examination you would find which of the following? - correct answer You would find mild upper respiratory symptoms with cough. And mild conjunctival injection. It is really indistinguishable from the common cold. What would NOT be considered a typical finding in a geriatric patient? - correct answer Low frequency hearing loss. A typical finding in a geriatric patient would be a high frequency hearing loss. The speaking voice is high frequency. Degenerative changes of the ossicles, fewer auditory neurons and atrophy of the hair cells results in sensorineural hearing loss. Typical findings in a geriatric patient? - correct answer Thinner epidermis, dermis and subcutaneous layers of skin, bright purple-colored patches on the forearms and hands, opaque white ring at the periphery of the cornea Risk factors for age-related macular degeneration - correct answer Tobacco use, aging, sun exposure and family history Underweight BMI - correct answer 18.5 Normal BMI - correct answer 18.5-24.9 Overweight BMI - correct answer 25-29.9 Obese BMI - correct answer 30-39.9 Grossly obese BMI - correct answer 40 Pregnancy Category A Drugs - correct answer Vitamins and levothyroxine Pregnancy Category B Drugs - correct answer Acetaminophen, ibuprofen, penicillins, cephalosporins, and azithromycin and erythromycin antibiotics. A geriatric patient who has a 40 pack-year smoking history complains of painful cramping in the leg muscles that occurs after walking for 20 minutes. After taking a complete history and performing a physical exam, an NP decides that the most likely diagnosis is? - correct answer Intermittent claudication What is a common cause of acne? - correct answer Increase in androgens In a 19-year-old who presents with a sore throat and anterior cervical adenopathy, which causative agent would be suspected? - correct answer Group A beta-hemolytic Streptococcus When completing the initial assessment for depression in geriatric adults, the NP should evaluate? - correct answer Mental status exam What is the most common risk factor for developing severe hyperbilirubinemia in the newborn? - correct answer Blood incompatibility with the mother Which trimester of pregnancy is a woman with a fundal height measurement at the umbilicus? - correct answer Second Which of the following conditions exacerbate urinary incontinence? - correct answer Impacted stool and atrophic vaginitis An adult patient presents with a 2-day history of intermittent stabbing chest pain that worsens with deep breaths. The patient reports a nonproductive cough and no fever for several days, and denies trauma, palpitations or GI symptoms. VS normal. Lungs are clear, heart sounds normal. PE reveals localized chest wall tenderness at the costal margin. EKG and CXR normal. The most likely diagnosis is? - correct answer Costchondritis The most common skin cancer is? - correct answer Basal cell carcinoma What is true regarding depression in the elderly? - correct answer Depression can be induced by prescribed and OTC medications Acute otitis media has what characteristics? - correct answer Loss of ossicular landmarks on the TM What constellations of symptoms, lasting more than 3 months, is MOST common in fibromyalgia? - correct answer Diffuse pain, sleep abnormality, fatigue An adult male is seen for an initial visit. He denies tobacco, drug, or ETOH use. He has a sedentary lifestyle and no family history of DM. VS normal, BMI = 31. What diabetes screening tests would an NP order? - correct answer Fasting plasma glucose An adolescent presents for a preparticipation athlete exam. In determining clearance for participation in sports, what should be considered? - correct answer Characteristics of the sport Urinary and bowel dysfunction, saddle anesthesia, and leg weakness or foot drop are signs of? - correct answer Cauda equina syndrome The NP would suspect what person to be at the highest risk for Rocky Mountain spotted fever? - correct answer A 40-year old male who is living in a wooded area raising dogs What condition is associated with the development of type 2 DM? - correct answer Delivery of a neonate weighing 9 lb or greater What condition is a risk factor for development of DVT and PE? - correct answer Visceral malignancy Research studies indicate that ED in geriatric patients is a common complication in? - correct answer Vascular disease What neuro signs are characteristic of the patient with AD? - correct answer Gait disorder and impaired stereognosis A frail elderly male patient complains of difficulty with urination. The International Prostate Symptom Score can assist with decisions regarding the diagnosis of BPH. What symptom is consistent with the items on this scale? - correct answer Nocturia The best medication for a patient who complains of IBS with cramping is? - correct answer Dicyclomine (Bentyl) Major causes of CKD include? - correct answer Amyloidosis and SLE A risk factor postmeno osteoporosis is? - correct answer History of tobacco use An NP considering referral of a frail elderly patient for hospice care understands that? - correct answer Documentation of limited life expectancy is a prerequisite The sound intensity of a grade III/VI hear murmur is typically described as? - correct answer Medium intensity What is associated with decreased risk of breast cancer? - correct answer Breast feeding An adult patient present with complaints of nausea, fatigue, and myalgia. The patient reports a history of untreated hep B 30 years ago. What hep B serology testing results would indicate that the patient has chronic hepatitis? - correct answer HBsAG = positive, IgM anti-HBc = negative A geriatric patient with anemia, back pain, osteoporosis, and elevated ESR should be evaluated for? - correct answer Multiple myeloma An older adult female presents with severe pain. She reports malaise, and periodic itching and burning on her chest wall. PE reveals a small area of hyperesthesia in a linear fashion. The most likely diagnosis is? - correct answer Herpes zoster An adult female presents complaining of an increase in a malodorous vaginal discharge that worsens after intercourse. Exam and testing reveal a vaginal pH of 5.5, presence of clue cells on the wet mount, and a positive whiff test. The most appropriate diagnosis is? - correct answer BV An adult patient presents with a painless ulcer in the genital area and enlarged lymph nodes in the groin. The NP suspects? - correct answer Syphilis An elderly retired farmed presents with a dome-shaped, pearly, firm nodule with telangiectasia on the side of his nose. An NP would recognize the nodule as a? - correct answer Basal cell carcinoma A child presents wit a reddened right eye. His mother states that he has been complaining of watering eyes with no purulent drainage. On exam, an enlarged preauricular node is identified. The NP should suspect: - correct answer Viral conjunctivitis A late adolescent football player presents to the UC with an acute knee injury. He heard a pop when his knee buckled. The NP notes a positive anterior drawer test. The most likely diagnosis is injury to the? - correct answer ACL A geriatric female complains of problems with urination. She reports that whenever she feels the need to urinate, she is unable to "make it to the bathroom in time," and wets herself. Which type of incontinence is most likely? - correct answer Urge An early adolescent patient who plays football presents to clinic after a football practice complaining of limping due to anterior left knee pain. The pain has gradually increased over the past 2 weeks but is relieved with rest. The patient denies any trauma, prior surgeries, or medical history. PE reveals tenderness and swelling of the tibial tubercle and reproduction of pain with resisted knee extension. The H&P exam findings are most consistent with a diagnosis of? - correct answer Osgood-Schlatter disease A late adolescent male presents with complaint that his left breast appears larger than the right one. He has a recent 10-lb weight gain and admits to MJ use. On exam, the area is diffuse and nontender, The primary diagnosis is? - correct answer Fatty gynecomastia An adult female patient present to the ED for sudden onset of severe lower abdominal pain. She describes the pain as stabbing. She denies nausea, vomiting, fever, or chills. The pain does not radiate. To confirm the diagnosis of an ectopic pregnancy, the NP should order what imaging study? - correct answer US A geriatric male, who is a 30-packs a year smoker, present with wheezing and dyspnea. His CXR shows a flattened diaphragm and an increased retrosternal chest space. There are decreased vascular markings. The most likely diagnosis is? - correct answer COPD A geriatric patient present with a bump on the vulva, associated with pruritis and malodorous drainage. Exam reveals a raised, ulcerated lesion. The most likely diagnosis is? - correct answer Vulvar cancer A pediatric patient presents with a painful, enlarged parotic gland. The most likely diagnosis is? - correct answer Mumps A geriatric female presents with tremors and a 20 lb weight loss over 2 months. An NP's lab eval should include a? - correct answer TSH and free T-4 A pregnant adult patient is diagnosed with a chlamydial infection at 20 weeks of gestation. What is the most accurate method for confirming this diagnosis? - correct answer Nucleic acid amplification test (NAAT) of urine An adult male presents with intermittent retrosternal burning. He has gained 30 lb in the past year. PE results are unremarkable and the EKG is normal. The most likely diagnosis is? - correct answer GERD A geriatric male patient is being followed for type 2 DM and HTN. He also has a diagnosis of polycythemia vera and has regular phlebotomies to control this. What statement about this patient is true? - correct answer He should avoid dietary iron supplements. An adult patient reports increasingly frequent migraines, especially upon rising in the morning. The headaches have been successfully managed in the past with APAP and Midrin prn, a neurological etiology has been ruled out. Of the following drugs, which would be recommended for prophylactic migraine management in this case? - correct answer Propranolol HCL (Inderal) 40 mg BID Long-term management of a patient with stable COPD includes: - correct answer Annual influenza vaccine For a late adolescent with acquired hypothyroidism who has been stable, a follow-up eval should be performed every? - correct answer 6-12 months An adult male with a BMI of 19 and continued GERD presents for follow-up visit after using OTH Pepcid for 6 weeks. What is the best next treatment option for this patient? - correct answer PPI A confused elderly female presents for the first time accompanied by her daughter. The patient is taking glipizide-metformin, lisinopril, glargine, ASA, and a multivitamin. What is the most likely cause of the patient's symptoms? - correct answer Hypoglycemia An adult male presents with general malaise and concerns about delayed ejaculation. His medication regimen consists of quinapril, paroxetine, loratadine, HCTZ. The delayed ejaculation is most likely caused by? - correct answer Paroxetine (Paxi) An NP is assessing a 4-day-old newborn. The parents brought the patient into the clinic the day before for concerns regarding breastfeeding. The newborn was assessed as jaundiced with a bilirubin level of 12 (elevated). The parents were instructed to increase breastfeeding and to return to clinic today. Today's assessment shows the newborn continues with jaundice and the bilirubin level is now 15.2. The NP should? - correct answer Prescribe phototherapy for the infant An elderly patient is diagnosed with acute gastritis. The patient stops taking Naproxen and is started on Pepcid. Three weeks later, the patient complains that the anorexia, nausea, and epigastric pain and tenderness have not been relieved. What diagnostic study should be ordered? - correct answer Testing for H. pylori A geriatric female was diagnosed with hypothyroidism and started on levothyroxine, 25 ug 1 week ago. She feels tired and wishes to have her medicine increased. What is the best response? - correct answer Your blood levels should be checked every 6 weeks, as it takes the body several weeks to adjust to the medication