AANP PRACTICE ACTUAL EXAM UPDATED 2024
75 QUESTIONS AND CORRECT 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
1
, 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 followi ng?
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)
2
, 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
3
75 QUESTIONS AND CORRECT 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
1
, 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 followi ng?
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)
2
, 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
3
