AANP AGPCNP PSI Test 1 & 2
QUESTIONS AND ANSWERS.
An 88-year-old presents with right-side weakness after being unable to rise unassisted
ji ji ji ji ji ji ji ji ji ji ji
following a fall to the bathroom floor. History includes aphasia and noncompliance with
ji ji ji ji ji ji ji ji ji ji ji ji ji
hypertension medication regimen. What is the most likely diagnosis?
ji ji ji ji ji ji ji ji ji
Left-sided or right-sided CVA? - (correct answer) -LEFT-SIDED CVA ji ji ji ji ji ji ji ji
Which of the following signs/symtpoms are often associated with headahces due to
ji ji ji ji ji ji ji ji ji ji ji
intracranial tumor?
ji ji
1) pain worse laying down, focal neurological signs
ji ji ji ji ji ji ji
2) Hyperflexia, personality change
ji ji ji
3) acute onset: hours to days
ji ji ji ji ji
4) pupillary constriction; stupor - (correct answer) -1) pain worse laying down, focal
ji ji ji ji ji ji ji ji ji ji ji ji
neurological signs
ji ji
Which of the following pharmacotherapeutics would be most important to administer to a
ji ji ji ji ji ji ji ji ji ji ji ji
patient who has a corneal abrasion?
ji ji ji ji ji ji ji
1) Timololji
2) Gentamicin ophthalmic
ji ji
3) Cromolyn optha
ji ji
4) Olopatadine - (correct answer) -2) Gentamicin ophthalmic (Genoptic)
ji ji ji ji ji ji ji ji
A 25-year-old presents with the chief complaint of decreased mobility and pain of the right
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
shoulder exacerbated by movement. The patient reports that he participated in extensive
ji ji ji ji ji ji ji ji ji ji ji ji
house painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
intact. No redness or ecchymosis is present. What is the next step to be taken in order to
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
make a diagnosis?
ji ji ji ji
1) Xray of shoulder
ji ji ji
2) Palpate structures around the shoulder.
ji ji ji ji ji ji
3) MRI of shoulder
ji ji ji
4) EMG - (correct answer) -2) palpate structures
ji ji ji ji ji ji ji
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
ji ji ji ji ji ji ji ji ji ji ji ji ji
spotting. She has not missed any doses and uses no other medication. Which of the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
following is appropriate?
ji ji ji ji
,1) Changing to Ortho-Novum 1/35
ji ji ji ji ji
2) Discontinue use
ji ji
3) Providing reassurance
ji ji ji
4) Double dose-for two days - (correct answer) -3) provide reassurance
ji ji ji ji ji ji ji ji ji ji
According to the Report of the U.S. Preventive Services Task Force, which of the following
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
is NOT a current recommendation guideline for preventive care in elderly female patients?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
1) Mammogram and clinical breast exams
ji ji ji ji ji
2) Fecal Occult blood test and/or sig
ji ji ji ji ji ji
3) Rubella serology or vaccination history
ji ji ji ji ji
4) Pnuemo and influenza vaccines - (correct answer) -3) Rubella serology or vaccination
ji ji ji ji ji ji ji ji ji ji ji ji
history
ji
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
The best action is to:
ji ji ji ji ji
1) initiate passive warming
ji ji ji
2) apply a rebreather
ji ji ji
3) Perform fluid replacement
ji ji ji
4) initiate active warming - (correct answer) -1) initiate passive rewarming
ji ji ji ji ji ji ji ji ji ji
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
would you educate this patient on recognizing the signs and symptoms of hypoglycemia?
ji ji ji ji ji ji ji ji ji ji ji ji ji
1) Edema ji
2) Tachycardia
ji
3) palpitations
ji
4) sweating - (correct answer) -4) sweating
ji ji ji ji ji ji
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of
ji ji ji ji ji ji ji ji ji ji ji
NSAIDs, stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-up
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
plan of care would be to:
ji ji ji ji ji ji
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
ji ji ji ji ji ji ji ji ji ji ji ji
2) continue NSAID, apply an arch support and encourage wt loss and exercise
ji ji ji ji ji ji ji ji ji ji ji ji
3) continue NSAID, xray and add a short-leg night splint
ji ji ji ji ji ji ji ji ji
4) COntinue NSAID, xray and add a metatarsal bar - (correct answer) -2) continue NSAID,
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
apply an arch support and encourage wt loss and exercise
ji ji ji ji ji ji ji ji ji ji
Fundoscopic exam of Hypertensive patient. ji ji ji ji
1) nicking of arteriols and viens, and small retinol hemorrages
ji ji ji ji ji ji ji ji ji
2) drusen bodies and pale retina
ji ji ji ji ji
3) pale macula and swollen disk margins
ji ji ji ji ji ji
,4) microaneurysms and optic disc cupping - (correct answer) -1) nicking of arteriols and
ji ji ji ji ji ji ji ji ji ji ji ji ji
viens, and small retinol hemorrages
ji ji ji ji ji
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
ji ji ji ji ji ji ji ji ji ji ji ji ji
1) elevated TSH
ji ji
2) Thyroid enlargement
ji ji
3) atrial fibrillation
ji ji
4) abnormal T3 suppression - (correct answer) -3) atrial fibrillation
ji ji ji ji ji ji ji ji ji
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since
ji ji ji ji ji ji ji ji ji ji ji
the previous day. The eye was rinsed with over-the-counter eyewash, without relief. The
ji ji ji ji ji ji ji ji ji ji ji ji ji
patient denies visual disturbances or drainage. In formulating a plan of care, the nurse
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
practitioner would FIRST:
ji ji ji
1) send to ophthalmologists
ji ji ji
2) florescreen staining
ji ji
3) test visual field
ji ji ji
4) prescribe eyedrops - (correct answer) -3) test visual field
ji ji ji ji ji ji ji ji ji
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical
ji ji ji ji ji ji ji ji ji ji ji ji ji
examination, the nurse practitioner notes the presence of a gray band of opacity in the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
cornea that encircles the iris. The band is 1.0-1.5 mm wide. This finding is most consistent
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
with a diagnosis of a/an:
ji ji ji ji ji
1. corneal abrasion
ji ji
2. arcus senilis
ji ji
3. corneal ulcer
ji ji
4. herpetic infection of the eye - (correct answer) -2) arcus senilis
ji ji ji ji ji ji ji ji ji ji ji
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night
ji ji ji ji ji ji ji ji ji ji ji ji
sweats, and a cough that has been present for 4 weeks. The diagnostic study to perform
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
first would be:
ji ji ji
1) xray ji
2) pulmonary function test
ji ji ji
3) bronchoscopy
ji
4) H & H - (correct answer) -1) xray (tb-night sweats)
ji ji ji ji ji ji ji ji ji ji
A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and
ji ji ji ji ji ji ji ji ji ji ji ji
fatigue. On physical examination, her lungs are clear bilaterally. There are a midsystolic
ji ji ji ji ji ji ji ji ji ji ji ji ji
click and a grade II/VI systolic murmur at the apex. Further evaluation would include which
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
of the following?
ji ji ji ji
1) EKG, flat plate of the abdomen, lipid profile
ji ji ji ji ji ji ji ji ji
, 2) Echocardiogram, Doppler, EKG
ji ji ji ji
3) Labs and benzo's
ji ji ji
4) EEG, Anxiety Scale, and electrolytes - (correct answer) -2) Echocardiogram, Doppler,
ji ji ji ji ji ji ji ji ji ji ji
EKG
ji
A healthy 84 y/o would like to start an exercise program, what would you do before this
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
takes place?
ji ji
1) physical exam
ji ji
2) EKG ji
3) knee xrays
ji ji
4) PT Stress test - (correct answer) -1) Physical Exam
ji ji ji ji ji ji ji ji ji
29 y/o has uncomplicated Chlamydia infection will exhibit:
ji ji ji ji ji ji ji
1) green penile discharge
ji ji ji
2) uticartia
ji
3) unremarkable symtpoms
ji ji
4) penile ulcer - (correct answer) -3) unremarkable symptoms
ji ji ji ji ji ji ji ji
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
1) spirometry
ji
2) MRI ji
3) COntract venogra[hy
ji ji
4) helical CT pulmonary angiograph - (correct answer) -4) helical CT pulmonary
ji ji ji ji ji ji ji ji ji ji ji
angiography.
ji
A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
irregular R-R interval. This arrhythmia is:
ji ji ji ji ji ji
1) atrial flutter
ji ji
2) atrial fibrillation
ji ji
3) second degree heart block
ji ji ji ji
4) Wolff-White Syndrome - (correct answer) -2) atrial fibrillation
ji ji ji ji ji ji ji ji
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing,
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
generalized musculoskeletal pain for several days. Pharmacologic management of this
ji ji ji ji ji ji ji ji ji ji
condition includes:
ji ji ji
1) Bactrimji
2) azithromycin
ji
3) doxycycline (Doryx).
ji ji ji
QUESTIONS AND ANSWERS.
An 88-year-old presents with right-side weakness after being unable to rise unassisted
ji ji ji ji ji ji ji ji ji ji ji
following a fall to the bathroom floor. History includes aphasia and noncompliance with
ji ji ji ji ji ji ji ji ji ji ji ji ji
hypertension medication regimen. What is the most likely diagnosis?
ji ji ji ji ji ji ji ji ji
Left-sided or right-sided CVA? - (correct answer) -LEFT-SIDED CVA ji ji ji ji ji ji ji ji
Which of the following signs/symtpoms are often associated with headahces due to
ji ji ji ji ji ji ji ji ji ji ji
intracranial tumor?
ji ji
1) pain worse laying down, focal neurological signs
ji ji ji ji ji ji ji
2) Hyperflexia, personality change
ji ji ji
3) acute onset: hours to days
ji ji ji ji ji
4) pupillary constriction; stupor - (correct answer) -1) pain worse laying down, focal
ji ji ji ji ji ji ji ji ji ji ji ji
neurological signs
ji ji
Which of the following pharmacotherapeutics would be most important to administer to a
ji ji ji ji ji ji ji ji ji ji ji ji
patient who has a corneal abrasion?
ji ji ji ji ji ji ji
1) Timololji
2) Gentamicin ophthalmic
ji ji
3) Cromolyn optha
ji ji
4) Olopatadine - (correct answer) -2) Gentamicin ophthalmic (Genoptic)
ji ji ji ji ji ji ji ji
A 25-year-old presents with the chief complaint of decreased mobility and pain of the right
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
shoulder exacerbated by movement. The patient reports that he participated in extensive
ji ji ji ji ji ji ji ji ji ji ji ji
house painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
intact. No redness or ecchymosis is present. What is the next step to be taken in order to
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
make a diagnosis?
ji ji ji ji
1) Xray of shoulder
ji ji ji
2) Palpate structures around the shoulder.
ji ji ji ji ji ji
3) MRI of shoulder
ji ji ji
4) EMG - (correct answer) -2) palpate structures
ji ji ji ji ji ji ji
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle
ji ji ji ji ji ji ji ji ji ji ji ji ji
spotting. She has not missed any doses and uses no other medication. Which of the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
following is appropriate?
ji ji ji ji
,1) Changing to Ortho-Novum 1/35
ji ji ji ji ji
2) Discontinue use
ji ji
3) Providing reassurance
ji ji ji
4) Double dose-for two days - (correct answer) -3) provide reassurance
ji ji ji ji ji ji ji ji ji ji
According to the Report of the U.S. Preventive Services Task Force, which of the following
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
is NOT a current recommendation guideline for preventive care in elderly female patients?
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
1) Mammogram and clinical breast exams
ji ji ji ji ji
2) Fecal Occult blood test and/or sig
ji ji ji ji ji ji
3) Rubella serology or vaccination history
ji ji ji ji ji
4) Pnuemo and influenza vaccines - (correct answer) -3) Rubella serology or vaccination
ji ji ji ji ji ji ji ji ji ji ji ji
history
ji
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10.
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
The best action is to:
ji ji ji ji ji
1) initiate passive warming
ji ji ji
2) apply a rebreather
ji ji ji
3) Perform fluid replacement
ji ji ji
4) initiate active warming - (correct answer) -1) initiate passive rewarming
ji ji ji ji ji ji ji ji ji ji
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
would you educate this patient on recognizing the signs and symptoms of hypoglycemia?
ji ji ji ji ji ji ji ji ji ji ji ji ji
1) Edema ji
2) Tachycardia
ji
3) palpitations
ji
4) sweating - (correct answer) -4) sweating
ji ji ji ji ji ji
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of
ji ji ji ji ji ji ji ji ji ji ji
NSAIDs, stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-up
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
plan of care would be to:
ji ji ji ji ji ji
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
ji ji ji ji ji ji ji ji ji ji ji ji
2) continue NSAID, apply an arch support and encourage wt loss and exercise
ji ji ji ji ji ji ji ji ji ji ji ji
3) continue NSAID, xray and add a short-leg night splint
ji ji ji ji ji ji ji ji ji
4) COntinue NSAID, xray and add a metatarsal bar - (correct answer) -2) continue NSAID,
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
apply an arch support and encourage wt loss and exercise
ji ji ji ji ji ji ji ji ji ji
Fundoscopic exam of Hypertensive patient. ji ji ji ji
1) nicking of arteriols and viens, and small retinol hemorrages
ji ji ji ji ji ji ji ji ji
2) drusen bodies and pale retina
ji ji ji ji ji
3) pale macula and swollen disk margins
ji ji ji ji ji ji
,4) microaneurysms and optic disc cupping - (correct answer) -1) nicking of arteriols and
ji ji ji ji ji ji ji ji ji ji ji ji ji
viens, and small retinol hemorrages
ji ji ji ji ji
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
ji ji ji ji ji ji ji ji ji ji ji ji ji
1) elevated TSH
ji ji
2) Thyroid enlargement
ji ji
3) atrial fibrillation
ji ji
4) abnormal T3 suppression - (correct answer) -3) atrial fibrillation
ji ji ji ji ji ji ji ji ji
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since
ji ji ji ji ji ji ji ji ji ji ji
the previous day. The eye was rinsed with over-the-counter eyewash, without relief. The
ji ji ji ji ji ji ji ji ji ji ji ji ji
patient denies visual disturbances or drainage. In formulating a plan of care, the nurse
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
practitioner would FIRST:
ji ji ji
1) send to ophthalmologists
ji ji ji
2) florescreen staining
ji ji
3) test visual field
ji ji ji
4) prescribe eyedrops - (correct answer) -3) test visual field
ji ji ji ji ji ji ji ji ji
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical
ji ji ji ji ji ji ji ji ji ji ji ji ji
examination, the nurse practitioner notes the presence of a gray band of opacity in the
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
cornea that encircles the iris. The band is 1.0-1.5 mm wide. This finding is most consistent
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
with a diagnosis of a/an:
ji ji ji ji ji
1. corneal abrasion
ji ji
2. arcus senilis
ji ji
3. corneal ulcer
ji ji
4. herpetic infection of the eye - (correct answer) -2) arcus senilis
ji ji ji ji ji ji ji ji ji ji ji
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night
ji ji ji ji ji ji ji ji ji ji ji ji
sweats, and a cough that has been present for 4 weeks. The diagnostic study to perform
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
first would be:
ji ji ji
1) xray ji
2) pulmonary function test
ji ji ji
3) bronchoscopy
ji
4) H & H - (correct answer) -1) xray (tb-night sweats)
ji ji ji ji ji ji ji ji ji ji
A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and
ji ji ji ji ji ji ji ji ji ji ji ji
fatigue. On physical examination, her lungs are clear bilaterally. There are a midsystolic
ji ji ji ji ji ji ji ji ji ji ji ji ji
click and a grade II/VI systolic murmur at the apex. Further evaluation would include which
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
of the following?
ji ji ji ji
1) EKG, flat plate of the abdomen, lipid profile
ji ji ji ji ji ji ji ji ji
, 2) Echocardiogram, Doppler, EKG
ji ji ji ji
3) Labs and benzo's
ji ji ji
4) EEG, Anxiety Scale, and electrolytes - (correct answer) -2) Echocardiogram, Doppler,
ji ji ji ji ji ji ji ji ji ji ji
EKG
ji
A healthy 84 y/o would like to start an exercise program, what would you do before this
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
takes place?
ji ji
1) physical exam
ji ji
2) EKG ji
3) knee xrays
ji ji
4) PT Stress test - (correct answer) -1) Physical Exam
ji ji ji ji ji ji ji ji ji
29 y/o has uncomplicated Chlamydia infection will exhibit:
ji ji ji ji ji ji ji
1) green penile discharge
ji ji ji
2) uticartia
ji
3) unremarkable symtpoms
ji ji
4) penile ulcer - (correct answer) -3) unremarkable symptoms
ji ji ji ji ji ji ji ji
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
1) spirometry
ji
2) MRI ji
3) COntract venogra[hy
ji ji
4) helical CT pulmonary angiograph - (correct answer) -4) helical CT pulmonary
ji ji ji ji ji ji ji ji ji ji ji
angiography.
ji
A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly
ji ji ji ji ji ji ji ji ji ji ji ji ji ji
irregular R-R interval. This arrhythmia is:
ji ji ji ji ji ji
1) atrial flutter
ji ji
2) atrial fibrillation
ji ji
3) second degree heart block
ji ji ji ji
4) Wolff-White Syndrome - (correct answer) -2) atrial fibrillation
ji ji ji ji ji ji ji ji
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing,
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and
ji ji ji ji ji ji ji ji ji ji ji ji ji ji ji
generalized musculoskeletal pain for several days. Pharmacologic management of this
ji ji ji ji ji ji ji ji ji ji
condition includes:
ji ji ji
1) Bactrimji
2) azithromycin
ji
3) doxycycline (Doryx).
ji ji ji
