AANp pMHNp ExAM QuEstioNs witH ANswErs
lAtEst 2023/2024
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) – ANs-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.
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 – ANs-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?
iNcorrEct
A.
iNsuliN AspArt 70/30
b.
iNsuliN dEtEMir
c.
iNsuliN isopHANE
d.
iNsuliN dEgludEc – ANs-iNsuliN isopHANE
,tHE lEAst ExpENsivE iNsuliN typE listEd iN tHis QuEstioN is iNsuliN isopHANE
© (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.
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 –
ANs-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
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.
lAtEst 2023/2024
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) – ANs-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.
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 – ANs-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?
iNcorrEct
A.
iNsuliN AspArt 70/30
b.
iNsuliN dEtEMir
c.
iNsuliN isopHANE
d.
iNsuliN dEgludEc – ANs-iNsuliN isopHANE
,tHE lEAst ExpENsivE iNsuliN typE listEd iN tHis QuEstioN is iNsuliN isopHANE
© (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.
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 –
ANs-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
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.
