AANP AGPCNP PSI TEST 1 & 2
An588-year-old5presents5with5right-
side5weakness5after5being5unable5to5rise5unassisted5following5a5fall5to5the5bathroom5fl
oor.5History5includes5aphasia5and5noncompliance5with5hypertension5medication5regim
en.5What5is5the5most5likely5diagnosis?
Left-sided5or5right-sided5CVA?5-5ans--✔✔LEFT-SIDED5CVA
Which5of5the5following5signs/
symtpoms5are5often5associated5with5headahces5due5to5intracranial5tumor?
1)5pain5worse5laying5down,5focal5neurological5signs
2)5Hyperflexia,5personality5change
3)5acute5onset:5hours5to5days
4)5pupillary5constriction;5stupor5-5ans--
✔✔1)5pain5worse5laying5down,5focal5neurological5signs
Which5of5the5following5pharmacotherapeutics5would5be5most5important5to5administer5t
o5a5patient5who5has5a5corneal5abrasion?5
1)5Timolol
2)5Gentamicin5ophthalmic
3)5Cromolyn5optha
4)5Olopatadine5-5ans--✔✔2)5Gentamicin5ophthalmic5(Genoptic)
A525-year-
old5presents5with5the5chief5complaint5of5decreased5mobility5and5pain5of5the5right5shoul
der5exacerbated5by5movement.5The5patient5reports5that5he5participated5in5extensive5h
ouse5painting5245hours5prior5to5the5onset5of5pain.5He5denies5any5trauma.5Passive5RO
M5is5intact.5No5redness5or5ecchymosis5is5present.5What5is5the5next5step5to5be5taken5i
n5order5to5make5a5diagnosis?5
1)5Xray5of5shoulder
2)5Palpate5structures5around5the5shoulder.5
3)5MRI5of5shoulder
4)5EMG5-5ans--✔✔2)5palpate5structures
,A516-year-old5female5in5the5first5month5of5taking5Ortho-
Novum57/7/75complains5of5midcycle5spotting.5She5has5not5missed5any5doses5and5use
s5no5other5medication.5Which5of5the5following5is5appropriate?5
1)5Changing5to5Ortho-Novum51/355
2)5Discontinue5use
3)5Providing5reassurance5
4)5Double5dose-for5two5days5-5ans--✔✔3)5provide5reassurance
According5to5the5Report5of5the5U.S.5Preventive5Services5Task5Force,5which5of5the5foll
owing5is5NOT5a5current5recommendation5guideline5for5preventive5care5in5elderly5femal
e5patients?5
1)5Mammogram5and5clinical5breast5exams
2)5Fecal5Occult5blood5test5and/or5sig
3)5Rubella5serology5or5vaccination5history
4)5Pnuemo5and5influenza5vaccines5-5ans--
✔✔3)5Rubella5serology5or5vaccination5history
875y/
o5NH5patient5is5drowsy5and5barely5responsive.5Temp595,5BP:5110/70,5Pulse560,5R510.
5The5best5action5is5to:
1)5initiate5passive5warming
2)5apply5a5rebreather
3)5Perform5fluid5replacement
4)5initiate5active5warming5-5ans--✔✔1)5initiate5passive5rewarming
A5patient5is5referred5with5DM,5HTN5and5CAD.5He5is5on5insulin5and5a5beta5blocker.5Ho
w5would5you5educate5this5patient5on5recognizing5the5signs5and5symptoms5of5hypoglyc
emia?
1)5Edema
2)5Tachycardia
3)5palpitations
4)5sweating5-5ans--✔✔4)5sweating
A565-year-
old5overweight5patient5is5diagnosed5with5plantar5fasciitis.5Initial5therapy5of5NSAIDs,5str
etching,5ice,5and5rest5has5proven5ineffective5after535weeks.5The5best5follow-
up5plan5of5care5would5be5to:
1)5stop5NSAID,5apply5a5heel5cup5and5encourage5exercise5and5wt5loss.
2)5continue5NSAID,5apply5an5arch5support5and5encourage5wt5loss5and5exercise
3)5continue5NSAID,5xray5and5add5a5short-leg5night5splint
,4)5COntinue5NSAID,5xray5and5add5a5metatarsal5bar5-5ans--
✔✔2)5continue5NSAID,5apply5an5arch5support5and5encourage5wt5loss5and5exercise
Fundoscopic5exam5of5Hypertensive5patient.
1)5nicking5of5arteriols5and5viens,5and5small5retinol5hemorrages
2)5drusen5bodies5and5pale5retina
3)5pale5macula5and5swollen5disk5margins
4)5microaneurysms5and5optic5disc5cupping5-5ans--
✔✔1)5nicking5of5arteriols5and5viens,5and5small5retinol5hemorrages
Which5of5the5following5is5a5common5presenting5feature5of5hyperthyroidism5in5the5elder
ly?
1)5elevated5TSH
2)5Thyroid5enlargement
3)5atrial5fibrillation
4)5abnormal5T35suppression5-5ans--✔✔3)5atrial5fibrillation
A535-year-
old5lawn5maintenance5worker5presents5reporting5"something5in5my5eye"5since5the5pre
vious5day.5The5eye5was5rinsed5with5over-the-
counter5eyewash,5without5relief.5The5patient5denies5visual5disturbances5or5drainage.5I
n5formulating5a5plan5of5care,5the5nurse5practitioner5would5FIRST:
1)5send5to5ophthalmologists
2)5florescreen5staining
3)5test5visual5field
4)5prescribe5eyedrops5-5ans--✔✔3)5test5visual5field
A572-year-
old5patient5presents5with5dry,5itchy5eyes.5During5the5course5of5the5physical5examinatio
n,5the5nurse5practitioner5notes5the5presence5of5a5gray5band5of5opacity5in5the5cornea5t
hat5encircles5the5iris.5The5band5is51.0-
1.55mm5wide.5This5finding5is5most5consistent5with5a5diagnosis5of5a/an:
1.5corneal5abrasion
2.5arcus5senilis
3.5corneal5ulcer
4.5herpetic5infection5of5the5eye5-5ans--✔✔2)5arcus5senilis
A526-year-
old5presents5with5reports5of5anorexia,5fatigue,5weight5loss,5malaise,5fever,5night5sweat
s,5and5a5cough5that5has5been5present5for545weeks.5The5diagnostic5study5to5perform5fi
rst5would5be:
, 1)5xray
2)5pulmonary5function5test
3)5bronchoscopy
4)5H5&5H5-5ans--✔✔1)5xray5(tb-night5sweats)
A544-year-
old5female5is5complaining5of5frequent5anxiety5attacks5with5chest5discomfort5and5fatigu
e.5On5physical5examination,5her5lungs5are5clear5bilaterally.5There5are5a5midsystolic5cli
ck5and5a5grade5II/
VI5systolic5murmur5at5the5apex.5Further5evaluation5would5include5which5of5the5followin
g?5
1)5EKG,5flat5plate5of5the5abdomen,5lipid5profile5
2)5Echocardiogram,5Doppler,5EKG5
3)5Labs5and5benzo's
4)5EEG,5Anxiety5Scale,5and5electrolytes5-5ans--✔✔2)5Echocardiogram,5Doppler,5EKG
A5healthy5845y/
o5would5like5to5start5an5exercise5program,5what5would5you5do5before5this5takes5place
?
1)5physical5exam
2)5EKG
3)5knee5xrays
4)5PT5Stress5test5-5ans--✔✔1)5Physical5Exam
295y/o5has5uncomplicated5Chlamydia5infection5will5exhibit:
1)5green5penile5discharge
2)5uticartia
3)5unremarkable5symtpoms
4)5penile5ulcer5-5ans--✔✔3)5unremarkable5symptoms
375has5suspected5PE.5c/o5anxiety5and5cough,5CXR5normal,5the5next5test5should5be:
1)5spirometry
2)5MRI
3)5COntract5venogra[hy
4)5helical5CT5pulmonary5angiograph5-5ans--✔✔4)5helical5CT5pulmonary5angiography.
A512-
lead5EKG5shows5an5undulating5baseline5with5no5visible5P5waves5and5an5irregularly5irr
egular5R-R5interval.5This5arrhythmia5is:
1)5atrial5flutter
An588-year-old5presents5with5right-
side5weakness5after5being5unable5to5rise5unassisted5following5a5fall5to5the5bathroom5fl
oor.5History5includes5aphasia5and5noncompliance5with5hypertension5medication5regim
en.5What5is5the5most5likely5diagnosis?
Left-sided5or5right-sided5CVA?5-5ans--✔✔LEFT-SIDED5CVA
Which5of5the5following5signs/
symtpoms5are5often5associated5with5headahces5due5to5intracranial5tumor?
1)5pain5worse5laying5down,5focal5neurological5signs
2)5Hyperflexia,5personality5change
3)5acute5onset:5hours5to5days
4)5pupillary5constriction;5stupor5-5ans--
✔✔1)5pain5worse5laying5down,5focal5neurological5signs
Which5of5the5following5pharmacotherapeutics5would5be5most5important5to5administer5t
o5a5patient5who5has5a5corneal5abrasion?5
1)5Timolol
2)5Gentamicin5ophthalmic
3)5Cromolyn5optha
4)5Olopatadine5-5ans--✔✔2)5Gentamicin5ophthalmic5(Genoptic)
A525-year-
old5presents5with5the5chief5complaint5of5decreased5mobility5and5pain5of5the5right5shoul
der5exacerbated5by5movement.5The5patient5reports5that5he5participated5in5extensive5h
ouse5painting5245hours5prior5to5the5onset5of5pain.5He5denies5any5trauma.5Passive5RO
M5is5intact.5No5redness5or5ecchymosis5is5present.5What5is5the5next5step5to5be5taken5i
n5order5to5make5a5diagnosis?5
1)5Xray5of5shoulder
2)5Palpate5structures5around5the5shoulder.5
3)5MRI5of5shoulder
4)5EMG5-5ans--✔✔2)5palpate5structures
,A516-year-old5female5in5the5first5month5of5taking5Ortho-
Novum57/7/75complains5of5midcycle5spotting.5She5has5not5missed5any5doses5and5use
s5no5other5medication.5Which5of5the5following5is5appropriate?5
1)5Changing5to5Ortho-Novum51/355
2)5Discontinue5use
3)5Providing5reassurance5
4)5Double5dose-for5two5days5-5ans--✔✔3)5provide5reassurance
According5to5the5Report5of5the5U.S.5Preventive5Services5Task5Force,5which5of5the5foll
owing5is5NOT5a5current5recommendation5guideline5for5preventive5care5in5elderly5femal
e5patients?5
1)5Mammogram5and5clinical5breast5exams
2)5Fecal5Occult5blood5test5and/or5sig
3)5Rubella5serology5or5vaccination5history
4)5Pnuemo5and5influenza5vaccines5-5ans--
✔✔3)5Rubella5serology5or5vaccination5history
875y/
o5NH5patient5is5drowsy5and5barely5responsive.5Temp595,5BP:5110/70,5Pulse560,5R510.
5The5best5action5is5to:
1)5initiate5passive5warming
2)5apply5a5rebreather
3)5Perform5fluid5replacement
4)5initiate5active5warming5-5ans--✔✔1)5initiate5passive5rewarming
A5patient5is5referred5with5DM,5HTN5and5CAD.5He5is5on5insulin5and5a5beta5blocker.5Ho
w5would5you5educate5this5patient5on5recognizing5the5signs5and5symptoms5of5hypoglyc
emia?
1)5Edema
2)5Tachycardia
3)5palpitations
4)5sweating5-5ans--✔✔4)5sweating
A565-year-
old5overweight5patient5is5diagnosed5with5plantar5fasciitis.5Initial5therapy5of5NSAIDs,5str
etching,5ice,5and5rest5has5proven5ineffective5after535weeks.5The5best5follow-
up5plan5of5care5would5be5to:
1)5stop5NSAID,5apply5a5heel5cup5and5encourage5exercise5and5wt5loss.
2)5continue5NSAID,5apply5an5arch5support5and5encourage5wt5loss5and5exercise
3)5continue5NSAID,5xray5and5add5a5short-leg5night5splint
,4)5COntinue5NSAID,5xray5and5add5a5metatarsal5bar5-5ans--
✔✔2)5continue5NSAID,5apply5an5arch5support5and5encourage5wt5loss5and5exercise
Fundoscopic5exam5of5Hypertensive5patient.
1)5nicking5of5arteriols5and5viens,5and5small5retinol5hemorrages
2)5drusen5bodies5and5pale5retina
3)5pale5macula5and5swollen5disk5margins
4)5microaneurysms5and5optic5disc5cupping5-5ans--
✔✔1)5nicking5of5arteriols5and5viens,5and5small5retinol5hemorrages
Which5of5the5following5is5a5common5presenting5feature5of5hyperthyroidism5in5the5elder
ly?
1)5elevated5TSH
2)5Thyroid5enlargement
3)5atrial5fibrillation
4)5abnormal5T35suppression5-5ans--✔✔3)5atrial5fibrillation
A535-year-
old5lawn5maintenance5worker5presents5reporting5"something5in5my5eye"5since5the5pre
vious5day.5The5eye5was5rinsed5with5over-the-
counter5eyewash,5without5relief.5The5patient5denies5visual5disturbances5or5drainage.5I
n5formulating5a5plan5of5care,5the5nurse5practitioner5would5FIRST:
1)5send5to5ophthalmologists
2)5florescreen5staining
3)5test5visual5field
4)5prescribe5eyedrops5-5ans--✔✔3)5test5visual5field
A572-year-
old5patient5presents5with5dry,5itchy5eyes.5During5the5course5of5the5physical5examinatio
n,5the5nurse5practitioner5notes5the5presence5of5a5gray5band5of5opacity5in5the5cornea5t
hat5encircles5the5iris.5The5band5is51.0-
1.55mm5wide.5This5finding5is5most5consistent5with5a5diagnosis5of5a/an:
1.5corneal5abrasion
2.5arcus5senilis
3.5corneal5ulcer
4.5herpetic5infection5of5the5eye5-5ans--✔✔2)5arcus5senilis
A526-year-
old5presents5with5reports5of5anorexia,5fatigue,5weight5loss,5malaise,5fever,5night5sweat
s,5and5a5cough5that5has5been5present5for545weeks.5The5diagnostic5study5to5perform5fi
rst5would5be:
, 1)5xray
2)5pulmonary5function5test
3)5bronchoscopy
4)5H5&5H5-5ans--✔✔1)5xray5(tb-night5sweats)
A544-year-
old5female5is5complaining5of5frequent5anxiety5attacks5with5chest5discomfort5and5fatigu
e.5On5physical5examination,5her5lungs5are5clear5bilaterally.5There5are5a5midsystolic5cli
ck5and5a5grade5II/
VI5systolic5murmur5at5the5apex.5Further5evaluation5would5include5which5of5the5followin
g?5
1)5EKG,5flat5plate5of5the5abdomen,5lipid5profile5
2)5Echocardiogram,5Doppler,5EKG5
3)5Labs5and5benzo's
4)5EEG,5Anxiety5Scale,5and5electrolytes5-5ans--✔✔2)5Echocardiogram,5Doppler,5EKG
A5healthy5845y/
o5would5like5to5start5an5exercise5program,5what5would5you5do5before5this5takes5place
?
1)5physical5exam
2)5EKG
3)5knee5xrays
4)5PT5Stress5test5-5ans--✔✔1)5Physical5Exam
295y/o5has5uncomplicated5Chlamydia5infection5will5exhibit:
1)5green5penile5discharge
2)5uticartia
3)5unremarkable5symtpoms
4)5penile5ulcer5-5ans--✔✔3)5unremarkable5symptoms
375has5suspected5PE.5c/o5anxiety5and5cough,5CXR5normal,5the5next5test5should5be:
1)5spirometry
2)5MRI
3)5COntract5venogra[hy
4)5helical5CT5pulmonary5angiograph5-5ans--✔✔4)5helical5CT5pulmonary5angiography.
A512-
lead5EKG5shows5an5undulating5baseline5with5no5visible5P5waves5and5an5irregularly5irr
egular5R-R5interval.5This5arrhythmia5is:
1)5atrial5flutter
