The American Academy of Nurse Practitioners Certification Board
AANP AGPCNP PSI Test 1 & 2 Latest Fall 2025 (Answered
and Graded A+)
An 88-year-old presents with right-side weakness after being unable to rise unassisted following a fall
to the bathroom floor. History includes aphasia and noncompliance with hypertension medication
regimen. What is the most likely diagnosis? Left-sided or right-sided CVA? - CORRECT ANS>>LEFT-
SIDED CVA
Which of the following signs/symptoms are often associated with headaches due to intracranial
tumor?
- CORRECT ANS>>1) pain worse laying down, focal neurological signs
Which of the following pharmacotherapeutics would be most important to administer to a patient
who has a corneal abrasion?
- CORRECT ANS>>2) Gentamicin ophthalmic (Genoptic)
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 or
ecchymosis is present. What is the next step to be taken in order to make a diagnosis?
- CORRECT ANS>>2) palpate structures
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting.
She has not missed any doses and uses no other medication. Which of the following is appropriate?
- CORRECT ANS>>3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a
current recommendation guideline for preventive care in elderly female patients?
- CORRECT ANS>>3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The best
action is to:
- CORRECT ANS>>1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would you
educate this patient on recognizing the signs and symptoms of hypoglycemia?
- CORRECT ANS>>4) sweating
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs,
stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-up plan of care would be
to:
- CORRECT ANS>>2) continue NSAID, apply an arch support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
,The American Academy of Nurse Practitioners Certification Board
- CORRECT ANS>>1) nicking of arteriols and veins, and small retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
- CORRECT ANS>>3) atrial fibrillation
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the previous
day. The eye was rinsed with over-the-counter eyewash, without relief. The patient denies visual
disturbances or drainage. In formulating a plan of care, the nurse practitioner would FIRST:
- CORRECT ANS>>3) test visual field
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, the
nurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris.
The band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
- CORRECT ANS>>2) arcus senilis
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and
a cough that has been present for 4 weeks. The diagnostic study to perform first would be:
- CORRECT ANS>>1) xray (tb-night sweats)
A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On
physical examination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI
systolic murmur at the apex. Further evaluation would include which of the following?
- CORRECT ANS>>2) Echocardiogram, Doppler, EKG
A healthy 84 y/o would like to start an exercise program, what would you do before this takes place?
- CORRECT ANS>>1) Physical Exam
29 y/o has uncomplicated Chlamydia infection will exhibit:
- CORRECT ANS>>3) unremarkable symptoms
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
- CORRECT ANS>>4) helical CT pulmonary angiography.
A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly irregular R-R
interval. This arrhythmia is:
- CORRECT ANS>>2) atrial fibrillation
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing, located in
the inguinal area. The patient has had a severe headache, malaise, fatigue, and generalized
musculoskeletal pain for several days. Pharmacologic management of this condition includes:
- CORRECT ANS>>3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with
Western Blot)
, The American Academy of Nurse Practitioners Certification Board
According to the American Diabetes Association, the newest standard for determining the presence of
diabetes mellitus based on fasting plasma sugar level is a value equal to or greater than:
- CORRECT ANS>>2) 126 mg/dl
In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves:
- CORRECT ANS>>2) loss of vascular tissue elasticity
A 58-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?
- CORRECT ANS>>1) polymyalgia rheumatica
An 85-year-old male relates that on the way to his annual physical examination; he suffered a sudden
loss of vision in his right eye characterized by "a bunch of lights" and a feeling that "a curtain came
down." All of the following would be included in the differential diagnosis EXCEPT:
- CORRECT ANS>>3) diabetic retinopathy
A patient with 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 self blood glucose
monitoring reveals increased morning levels. After an increase in the evening insulin dose, the
problem worsens. This is most likely an example of:
- CORRECT ANS>>2) Somogyi effect
In a healthy elder, which of the following TRADITIONALLY defines a positive urine culture?
- CORRECT ANS>>≥100,000 colonies/mL of a single organism
A 55-year-old patient exhibits a verified serum calcium level of 13 mg/dL [normal = 8.9-10.2 mg/dL].
The next step in determining the presence of pathology is to order a:
- CORRECT ANS>>3) parathyroid hormone level
An 88-year-old female presents with a 3-day history of vertigo. The patient has a past medical history
of hypertension controlled with metoprolol, 50 mg daily. She reports that the presenting symptoms
are constant, severe, and accompanied by nausea and vomiting. She denies experiencing diplopia,
slurring of speech, chest pain, dyspnea, or diaphoresis. She exhibits mild anxiety and reluctance to
change position or turn the head. BP = 126/76; P = 78; R = 16/min; and T = 98.2°F (36.8°C). HEENT
examination reveals 17 beats of horizontal nystagmus on right lateral gaze; the nystagmus stops after
several repetitions of the maneuver. Funduscopic, cardiac, pulmonary, abdominal, and neurologic
examination results are normal. The most likely diagnosis is:
- CORRECT ANS>>2) vestibular neuritis
When initiating thyroid hormone replacement in the older adult, care must be taken to evaluate the
- CORRECT ANS>>1) coronary status
AANP AGPCNP PSI Test 1 & 2 Latest Fall 2025 (Answered
and Graded A+)
An 88-year-old presents with right-side weakness after being unable to rise unassisted following a fall
to the bathroom floor. History includes aphasia and noncompliance with hypertension medication
regimen. What is the most likely diagnosis? Left-sided or right-sided CVA? - CORRECT ANS>>LEFT-
SIDED CVA
Which of the following signs/symptoms are often associated with headaches due to intracranial
tumor?
- CORRECT ANS>>1) pain worse laying down, focal neurological signs
Which of the following pharmacotherapeutics would be most important to administer to a patient
who has a corneal abrasion?
- CORRECT ANS>>2) Gentamicin ophthalmic (Genoptic)
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 or
ecchymosis is present. What is the next step to be taken in order to make a diagnosis?
- CORRECT ANS>>2) palpate structures
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting.
She has not missed any doses and uses no other medication. Which of the following is appropriate?
- CORRECT ANS>>3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a
current recommendation guideline for preventive care in elderly female patients?
- CORRECT ANS>>3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The best
action is to:
- CORRECT ANS>>1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would you
educate this patient on recognizing the signs and symptoms of hypoglycemia?
- CORRECT ANS>>4) sweating
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs,
stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-up plan of care would be
to:
- CORRECT ANS>>2) continue NSAID, apply an arch support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
,The American Academy of Nurse Practitioners Certification Board
- CORRECT ANS>>1) nicking of arteriols and veins, and small retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
- CORRECT ANS>>3) atrial fibrillation
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the previous
day. The eye was rinsed with over-the-counter eyewash, without relief. The patient denies visual
disturbances or drainage. In formulating a plan of care, the nurse practitioner would FIRST:
- CORRECT ANS>>3) test visual field
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, the
nurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris.
The band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
- CORRECT ANS>>2) arcus senilis
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and
a cough that has been present for 4 weeks. The diagnostic study to perform first would be:
- CORRECT ANS>>1) xray (tb-night sweats)
A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On
physical examination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI
systolic murmur at the apex. Further evaluation would include which of the following?
- CORRECT ANS>>2) Echocardiogram, Doppler, EKG
A healthy 84 y/o would like to start an exercise program, what would you do before this takes place?
- CORRECT ANS>>1) Physical Exam
29 y/o has uncomplicated Chlamydia infection will exhibit:
- CORRECT ANS>>3) unremarkable symptoms
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
- CORRECT ANS>>4) helical CT pulmonary angiography.
A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly irregular R-R
interval. This arrhythmia is:
- CORRECT ANS>>2) atrial fibrillation
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing, located in
the inguinal area. The patient has had a severe headache, malaise, fatigue, and generalized
musculoskeletal pain for several days. Pharmacologic management of this condition includes:
- CORRECT ANS>>3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with
Western Blot)
, The American Academy of Nurse Practitioners Certification Board
According to the American Diabetes Association, the newest standard for determining the presence of
diabetes mellitus based on fasting plasma sugar level is a value equal to or greater than:
- CORRECT ANS>>2) 126 mg/dl
In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves:
- CORRECT ANS>>2) loss of vascular tissue elasticity
A 58-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?
- CORRECT ANS>>1) polymyalgia rheumatica
An 85-year-old male relates that on the way to his annual physical examination; he suffered a sudden
loss of vision in his right eye characterized by "a bunch of lights" and a feeling that "a curtain came
down." All of the following would be included in the differential diagnosis EXCEPT:
- CORRECT ANS>>3) diabetic retinopathy
A patient with 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 self blood glucose
monitoring reveals increased morning levels. After an increase in the evening insulin dose, the
problem worsens. This is most likely an example of:
- CORRECT ANS>>2) Somogyi effect
In a healthy elder, which of the following TRADITIONALLY defines a positive urine culture?
- CORRECT ANS>>≥100,000 colonies/mL of a single organism
A 55-year-old patient exhibits a verified serum calcium level of 13 mg/dL [normal = 8.9-10.2 mg/dL].
The next step in determining the presence of pathology is to order a:
- CORRECT ANS>>3) parathyroid hormone level
An 88-year-old female presents with a 3-day history of vertigo. The patient has a past medical history
of hypertension controlled with metoprolol, 50 mg daily. She reports that the presenting symptoms
are constant, severe, and accompanied by nausea and vomiting. She denies experiencing diplopia,
slurring of speech, chest pain, dyspnea, or diaphoresis. She exhibits mild anxiety and reluctance to
change position or turn the head. BP = 126/76; P = 78; R = 16/min; and T = 98.2°F (36.8°C). HEENT
examination reveals 17 beats of horizontal nystagmus on right lateral gaze; the nystagmus stops after
several repetitions of the maneuver. Funduscopic, cardiac, pulmonary, abdominal, and neurologic
examination results are normal. The most likely diagnosis is:
- CORRECT ANS>>2) vestibular neuritis
When initiating thyroid hormone replacement in the older adult, care must be taken to evaluate the
- CORRECT ANS>>1) coronary status
