AANP FNP FOCUST ExAm REviEw wiTh ExAm QUESTiONS ANd ACCURATE SOlUTiONS UPdATEd 2026/2027||100% GUARANTEEd PASS A+ GRAdEd<<BRANd NEw vERSiON>>

Skin condition that can manifest when stressed. Itchy and dries up like cream colored sand paper before healing - ANSWER Eczema diabetic retinopathy - ANSWER Diabetic Retinopathy-Cotton wool spots (moderate retinopathy), micro-aneurysms. ALSO RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR ORANGE RED Where is the site for most breast tumors in women? - ANSWER Upper outer quadrant An adult male presents as first patient of the day after awaking about 5:00 AM with indigestion and chest pressure. On checking his pulse, he found no change from previous measurements. He states that, while waiting for the nurse practitioner to arrive, he began to feel a little clammy. A 12-lead EKG records the following patterns. On the basis of these EKG readings, the diagnosis is: 1. anterior-septal acute myocardial infarction. 2. lateral acute myocardial infarction. 3. inferior acute myocardial infarction. 4. anterior acute myocardial infarction. - ANSWER inferior acute myocardial infarction During the past 24 hours, a 62-year-old has experienced abdominal pain that radiates to the back. The patient also reports several episodes of nausea and vomiting, a low-grade temperature, and a history of excessive drinking. Physical examination reveals a distended abdomen. Laboratory serum values indicate elevated alkaline phosphatase, amylase, and serum lipase. The most likely diagnosis is: 1. alcoholic liver disease. 2. acute mesenteric ischemia. 3. viral hepatitis. 4. acute pancreatitis. - ANSWER acute pancreatitis An otherwise healthy adult female presents complaining of vaginal burning and itching during urination. She has a social history of two sexual partners. She denies fever or vaginal discharge, but has noted a lesion on one labium. The nurse practitioner should order all of the following EXCEPT: 1. wet mount and potassium hydroxide. 2. dark-field microscopy of fluid from the lesion. 3. nucleic acid amplification testing for gonorrhea. 4. serology for Haemophilus ducreyi. - ANSWER dark-field microscopy of fluid from lesion A 3-year-old female has been diagnosed with bacterial meningitis. She attends preschool daily at a local church day care program. The day before her diagnosis, she ate lunch with her mother at a local restaurant. For which contact(s) would chemoprophylaxis with rifampin be recommended? 1. Preschool contacts in the past 7 days 2. A friend of the patient's sister who visited after school yesterday 3. The checkout employee at the grocery store yesterday 4. Diners at the restaurant during lunch the day the patient ate there - ANSWER preschool contacts in past 7 days Congenital dysplasia of the hip: 1. more commonly affects both hips. 2. occurs more commonly in females. 3. is correctable at any age. 4. typically self-corrects by 12 weeks of age. - ANSWER more commonly affects both hips Anticholinergic agents such as ipratropium (Atrovent) and tiotropium (Spiriva) are used in COPD primarily to: 1. induce bronchodilation. 2. decrease airway inflammation. 3. expand the lung fields. 4. treat hypoxemia. - ANSWER induce bronchodilation The clinical presentation of placenta previa that develops during the third trimester includes: 1. intermittent dark-red spotting. 2. occult bleeding with abdominal or back pain. 3. sudden onset of painless and profuse bleeding. 4. painless occult bleeding that becomes visible upon onset of labor. - ANSWER sudden onset of painless and profuse bleeding A 27-year-old male patient, who works as a janitor, presents with a 6-month history of an intermittent rash on his hands. History reveals itching and occasional burning. Examination reveals irregularly-distributed scaly maculopapular erythematous patches extending from the dorsum of the hand several inches up the forearms, and dry palms with no nail involvement. The most likely diagnosis is: 1. contact dermatitis. 2. scabies infestation. 3. psoriasis. 4. eczema. - ANSWER contact dermatitis Anorexia nervosa occurs most commonly in which of the following? 1. Painters 2. Only children 3. High-level athletes 4. Individuals from large families - ANSWER high level athletes A frail elderly patient presents with constipation. Which of the following normal physiologic changes seen with aging is the most likely cause? 1. Decreased bowel muscle tone 2. Increased bile secretion 3. Increased absorption of calcium 4. Decreased pancreatic secretions - ANSWER decreased bowel muscle tone A patient reports to your office, having been struck on the right cheek with a baseball bat. On examination, you notice tenderness and swelling over the cheek. The patient is unable to gaze laterally with his left eye, and he complains of double vision when he attempts to do so. This is most likely associated with: 1. retinal hemorrhage. 2. orbital rim fracture. 3. subarachnoid hemorrhage. 4. periorbital cellulitis. - ANSWER orbital rim fractures A 7-year-old child presents with group A streptococcal infection confirmed by throat culture. Past history includes treatment for positive streptococcal infection with erythromycin (EryPed oral suspension) 3 weeks ago. What is the most appropriate next intervention? 1. Treat with amoxicillin for 10 days. 2. Obtain culture for all household members. 3. Treat with azithromycin (Zithromax) for 10 days. 4. Intramuscular Penicillin. - ANSWER treat with amoxicillin for 10 days A 16-year-old female adolescent is brought to the nurse practitioner's office by her mother, who is concerned about her daughter's recent weight loss. History reveals that the daughter was consistently in the 50th percentile for weight, but is now in the 10th percentile. The mother states that she is concerned that her daughter is purging herself after meals since she often goes to the restroom after eating and remains there for a long period of time. The daughter denies any self-induced vomiting, starvation or excessive activity. She does state that she jogs five miles a day and is in good condition. In addition to a complete blood count with differential, which of the following laboratory tests will be most helpful for further assessment? 1. Electrolytes, fasting blood sugar 2. Creatine phosphokinase, follicle-stimulating hormone (FSH) 3. Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis 4. Electrolyt - ANSWER electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis An adult female who is homeless presents for an initial obstetric visit at 34 weeks of pregnancy. She is diagnosed with Chlamydia trachomatis infection. What complication will her newborn be most at risk? 1. Conjunctivitis 2. Hearing loss 3. Pneumonitis 4. Meningitis - ANSWER conjunctivitis A 2-year-old male presents for reevaluation. Two days ago, he had four episodes of vomiting and six diarrheal stools. On physical examination today, his vital signs reveal P = 120 and capillary refill of 3 seconds. The patient's eyes are sunken and his extremities are mottled and cool to the touch. The treatment plan would include: 1. start oral electrolyte mixture every hour. 2. hospitalization for IV fluid replacement. 3. giving the child loperamide for each diarrheal stool. 4. catheterizing the child to obtain accurate urine output. - ANSWER hospitalization for IV fluid replacement A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d. for angina. The patient is unable to remember to take the medication at the scheduled times. The practitioner should: 1. discontinue the issue with the patient's daughter. 2. change the dose to extended release 30 mg daily. 3. reinforce the importance of taking the medication. 4. increase the dosage to 20 mg b.i.d. - ANSWER change the dose to extended release 30mg daily A pediatric male is present with his mother, who states that he is extremely restless at night and constantly scratches his anal area. Which diagnostic procedure would confirm a diagnosis of pinworm infestation? 1. The patch test 2. Examination of bed linens 3. Examination of transparent tape sample from perianal skin 4. Blood tests for anemia and eosinophilia - ANSWER examination of transparent tape sample from perianal skin Which of the following microorganisms are most frequently associated with acute bacterial rhino-sinusitis? 1. Staphylococcus aureus and Mycoplasma pneumonia 2. Staphylococcus aureus and Methicillin Resistant Staph aureus 3. Streptococcus pneumoniae and Haemophilus influenzae 4. Streptococcus pneumoniae and Pseudomonas aeruginosa - ANSWER strep pneumo and haemophilus influenzae A child is being treated with methylphenidate (Ritalin) for attention-deficit disorder. The following are all side effects of Ritalin EXCEPT: 1. muscle cramps 2. mild irritability. 3. increased heart rate. 4. slight increase in growth velocity. - ANSWER slight increase in growth velocity A geriatric female presents for her annual examination. She has been on antihypertensive medications for over 20 years, with good control. Laboratory values are within normal ranges. The nurse practitioner is concerned about the patient's cardiac health risks, due her to weight and her waist circumference. According to the AHA guidelines, which of the following goals is expected for this patient? 1. Physical activity for 60 minutes daily, for a minimum of 6 days a week 2. Physical activity for 30 minutes daily, 7 days a week 3. Physical activity for 30 minutes daily, for a minimum of 5 days a week 4. Physical activity for 60 minutes daily, 7 days a week - ANSWER physical activity for 30 minutes daily, for a minimum of 5 days a week The management of COPD in the elderly is best guided by: 1. spirometry. 2. arterial blood gases. 3. radiologic imaging. 4. symptomatology. - ANSWER symptomatology A young, athletic adult presents with shoulder pain and inability to raise the arm above the shoulder. The most likely diagnosis is: 1. frozen shoulder syndrome. 2. cervical radiculopathy. 3. rotator cuff tear. 4. polymyositis. - ANSWER rotator cuff tear A 50-year-old male presents with bruises and abrasions on the left leg and forearm, claiming to have had a number of minor accidents at home and at work. The patient reports general feelings of depression, forgetfulness, and, despite the fact that he is regularly employed, a mounting collection of unpaid and overdue bills. In taking the patient's history, a significant pattern of parental alcohol abuse, stroke, TIA, and MI emerges. During questioning to elicit a more thorough diagnosis, the patient becomes hostile and leaves the clinic without further treatment. The most likely explanation for this behavior is: 1. Alzheimer's disease. 2. chronic alcoholism. 3. cancer. 4. carotid artery stenosis. - ANSWER chronic alcoholism A 28-year-old patient presents with profuse yellow vaginal discharge, odor, and local irritation. She reports completing a 7-day course of oral metronidazole (Flagyl), 500 mg b.i.d. 4 weeks ago. She has had multiple recurrences over the last 18 months. Microscopic examination reveals presence of clue cells. What is the most appropriate treatment intervention? 1. Oral metronidazole (Flagyl), 500 mg b.i.d., plus metronidazole vaginal gel (MetroGel), for 5 days 2. Treat both patient and partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d., for 7 days 3. Metronidazole vaginal gel (MetroGel) twice weekly for 4 to 6 months 4. Treat patient with metronidazole vaginal gel (MetroGel) b.i.d. and partner(s) with tetracycline, 250 mg q.i.d., for 7 days - ANSWER Treat both patient and partner(s) with oral metronidazole (Flagyl), 500 mg b.i.d., for 7 days An adult female who recently returned from a business trip to Japan presents for a recheck appointment. The only remarkable laboratory result is for thyroidstimulating hormone (TSH), at 0.3 microunits/mL (normal = 0.4-6 microunits/mL). The patient reports that her neck hurts; examination reveals thyroid tenderness. Which of the following laboratory tests should the nurse practitioner order now? 1. Triiodothyronine (T3) and free thyroxine (FT4) 2. Triiodothyronine (T3) only 3. Triiodothyronine (T3) resin uptake assay 4. Triiodothyronine (T3) and free triiodothyronine (FT3) - ANSWER Triiodothyronine (T3) and free thyroxine (FT4) In treating a pregnant female with migraine headaches, which of the following drugs is in Category X? 1. Ergotamine tartrate (Ergomar) 2. Sumitriptan succinate (Imitrex) 3. Frovatriptan (Frova) 4. Amitriptyline (Elavil) - ANSWER ergotamine tartate (ergomar) A nurse practitioner is evaluating an infant for possible colic. Which of the following could indicate the need for a more extensive evaluation? 1. 3-oz (85 g) weight gain over the past 2 weeks 2. Stool negative for occult blood 3. Moist mucus membranes and flat fontanels 4. Onset at 4 weeks of age - ANSWER 3-oz (85 g) weight gain over the past 2 weeks Which of the following is a hallmark of lumbar spinal stenosis? 1. Incontinence of bowel and/or bladder 2. Point tenderness of the lumbar spine 3. Leg, buttock or back pain precipitated by walking. 4. Bilateral leg pain with sitting. - ANSWER leg, buttock or back pain precipitated by walking A 70-year-old patient presents to the clinic complaining of dyspnea, palpitations, and fatigue. The patient reports a 2-week history of blackened stools, which the patient attributes to drinking berry juice. Assessment reveals vital signs of BP = 110/60, P = 100, R = 24; Hgb = 4.5 g/dL; Hct = 16%. What is the most appropriate immediate intervention? 1. Order serum iron, total iron-binding capacity (TIBC), and ferritin. 2. Refer to a gastroenterologist. 3. Send to the emergency room. 4. Order a complete blood count (CBC) with differential. - ANSWER Send to emergency room A 2-year-old male presents for reevaluation. Two days ago, he had four episodes of vomiting and six diarrheal stools. On physical examination today, his vital signs reveal P = 120 and capillary refill of 3 seconds. The patient's eyes are sunken and his extremities are mottled and cool to the touch. The treatment plan would include: 1. start oral electrolyte mixture every hour. 2. hospitalization for IV fluid replacement. 3. giving the child loperamide for each diarrheal stool. 4. catheterizing the child to obtain accurate urine output. - ANSWER hospitalization for IV fluid replacement A 17-year-old female has never had her menses. She is at Tanner stage III of sexual development. Her physical examination is completely normal, and her weight is appropriate for her age and height. What is the most likely diagnosis? - ANSWER Primary amenorrhea Palm Sign - ANSWER palm of the hand to the chest = ischemic chest pain Osteoporosis is defined as T-score - ANSWER -2.5 and less Dystonia - ANSWER involuntary repetitive muscle movements muscle spasms Paraphimosis - ANSWER Retracted foreskin that cannot be brought forward to cover the glans. Potential urologic emergency. S/s of retinal detachment? - ANSWER Feels like curtian coming over vision, flashes of light OTHERS? TX? Osteoarthritis s/s, first line tx - ANSWER Large weight bearing joints. Early morning stiffness with inactivity. Has both nodes. FIRST LINE Acetaminophen. Roseola - ANSWER Human herpesvirus 6. High fever for 2-4 days, then abrupt cessation of fever with appearance of maculopapular rash but not on face itraconazole - oral - ANSWER ... A nurse practitioner places a 76-year-old patient on nifedipine (Procardia) 10 mg t.i.d. for angina. The patient is unable to remember to take the medication at the scheduled times. The practitioner should: 1. discontinue the issue with the patient's daughter. 2. change the dose to extended release 30 mg daily. 3. reinforce the importance of taking the medication. 4. increase the dosage to 20 mg b.i.d. - ANSWER change the dose to extended release 30mg daily 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: - ANSWER 126 mg/dL. Arm Sign - ANSWER touching the left arm with right arm = ischemic chest pain Thayer-Martin culture - ANSWER Used to diagnose gonorrheal pharyngitis or proctitis Dyskinesia - ANSWER abnormal involuntary muscle rigidity Cryptorchidism - ANSWER Testicle located in inguinal canal or abdomen. Undescended testicle. S/s of epididimitis? - ANSWER ???? Prinse test Osteoarthritis recommended exercise - ANSWER EXERCISE: Isometric exercises for knee OA. Non-weight bearing, like biking, swimming, stationary bike. Fifth Disease - ANSWER Parvovirus B19. "Slapped cheek" rash. Lacy. Macular rash. griseofulvin - ANSWER tinea capitis A pediatric male is present with his mother, who states that he is extremely restless at night and constantly scratches his anal area. Which diagnostic procedure would confirm a diagnosis of pinworm infestation? 1. The patch test 2. Examination of bed linens 3. Examination of transparent tape sample from perianal skin 4. Blood tests for anemia and eosinophilia - ANSWER examination of transparent tape sample from perianal skin A 38-year-old male experiences a sudden onset of acute abdominal pain radiating to his groin. He is having difficulty walking and is nauseated. He denies any trauma or previous groin injuries. Examination reveals diffuse swelling of the left testicle and negative cremasteric reflex. The most likely diagnosis is: - ANSWER testicular torsion.