AANP FNP CERTIFICATION ACTUAL EXAM NEWEST
VERSION QUESTIONS AND CORRECT DETAILED
ANSWERS |ALREADYGRADED A+
Therapeutic INR values below ____ increase stroke risk sixfold. - Answer ✔✔ - 2
Diabetic Retinopathy Findings - Answer ✔✔ - Microaneurysms
Neovascularization
Cotton Wool Spots
Hard exudates
All of the following would require the nurse practitioner to delay testing a patient's
prostate-specific antigen (PSA), except:
a. Urinary retention
b. Urinary tract infection
c. After a digital rectal exam
d. Vigorous exercise 3 days prior - Answer ✔✔ - Vigorous exercise 3 days prior
PSA testing is falsely elevated in a patient with urinary retention and urinary tract infection
and after a digital rectal exam. Vigorous exercise does not have to be stopped 3 days prior
to testing; however, vigorous exercise should be discouraged before testing because it will
falsely elevate the PSA levels. Ejaculation within 48 hours will also falsely raise the PSA
level.
Tic Douloureaux - Answer ✔✔ - There are two types of tic douloureux (trigeminal
neuralgia).
,Type 1--presents with extreme, shock-like facial pain, which lasts from a few seconds to 2
minutes per event and can last up to 2 hours total. Type 1 does not awaken the patient at
night.
Type 2-- is a constant, aching, burning facial pain with less intensity but may occur with
Type 1. Type 2 is more common in women and peaks in their 60s. Type 2 can also be
related to secondary neurologic disease such as multiple sclerosis or HSV-1.
The nurse practitioner sees a 58-year-old female patient who reports abscesses and
pustules in the axilla and groin and under the breasts, which burst and drain purulent
green discharge. She has a history of smoking and a body mass index (BMI) of 37.1.
Which diagnosis is most likely?
a. Impetigo
b. Carbuncles
c. Shingles
d. Hidradenitis suppurativa - Answer ✔✔ - hidradenitis suppurativa
Hidradenitis suppurativa is most common in women (3:1). Smoking and obesity are
significant risk factors. Lesions are treated with topical antibiotics (or oral antibiotics,
warm compresses, and pain medications). Institute diet changes to reduce high glycemic
and dairy food intake. Refer to a dermatologist for additional treatment options.
Insulin Lispro (Humalog) - Answer ✔✔ - Lispro is a rapid-acting insulin that is used on a
sliding scale to work from meal to meal
Atopic dermatitis (eczema) - Answer ✔✔ - chronic, pruritic rash of the hands, flexural
folds, and neck that can be exacerbated by stress and environmental factors.
,Toxic Epidermal Necrolysis (TEN) - Answer ✔✔ - TEN is the result of a severe skin
reaction to medications such as allopurinol, nonsteroidal anti-inflammatory drugs
(NSAIDs), and anticonvulsants.
Melanoma - Answer ✔✔ - Melanoma are nevi with uneven texture, irregular borders,
variegated colors, size larger than 6 mm, and changing size (the mnemonic ABCDE stands
for asymmetry, border irregularity, color variations in the same region, diameter >6 mm,
and enlargement or change in size over time), and they can be pruritic. Risk factors include
family history of melanoma (10% of cases), extensive/intense sunlight exposure, blistering
sunburn in childhood, tanning beds, and atypical nevus
Seborrheic keratoses - Answer ✔✔ - Seborrheic keratoses are soft, fleshy, painless
growths that are located mostly on the back. Skin lesions look like they are "pasted" on the
skin and can range in color from light tan to black.
Acanthosis nigricans - Answer ✔✔ - Acanthosis nigricans are diffuse, soft thickenings of
the skin usually located at the neck and axilla. They are also associated with diabetes,
metabolic syndrome, obesity, and gastrointestinal cancer.
Acrochordon - Answer ✔✔ - Acrochordons (skin tags) are painless, pedunculated
outgrowths of skin that are common in the neck and axillary areas. If the growths are
traumatized, they become necrotic and fall off. They are most common in diabetics and
patients who are obese.
Which of the following is associated with male aging?
a. Increased levels of estrogen
b. Decreased sperm production
c. Increased production of semen
, d. Decreased concentration of sperm - Answer ✔✔ - Decreased sperm production
A nurse practitioner sees a patient for an evaluation of sexually transmitted diseases.
Assessment reveals Fitz-Hugh-Curtis. The nurse practitioner will prescribe: - Answer ✔✔ -
Ceftriaxone 500 mg IM × one dose plus doxycycline 100 mg BID × 14 days plus
metronidazole 500 mg BID × 14 days.
Fitz-Hugh-Curtis syndrome should be treated as a complicated gonorrheal/chlamydial
infection: Ceftriaxone 500 mg IM × one dose plus doxycycline 100 mg BID × 14 days plus
metronidazole 500 mg BID × 14 days for anaerobic coverage.
sensitive screening test for HIV - Answer ✔✔ - Combination HIV-1 and HIV-2 antibody
immunoassay with p24 antigen.
DM medication class that should not be used in patients with heart failure or hx of bladder
cancer? - Answer ✔✔ - Thiazolidinediones
Medication class with high risk of hypoglycemic events: - Answer ✔✔ - Sulfonylureas
stimulate the beta cells but have a long half-life, and there is a high risk for severe
hypoglycemic events.
Treponema pallidum - Answer ✔✔ - T. pallidum is a gram-negative spirochete bacterium
that causes syphilis.
Which class of diuretics is contraindicated in patients who are allergic to sulfa products? -
Answer ✔✔ - Thiazides (hydrochlorothiazide and indapamide) and loop diuretics
(furosemide and bumetanide) are contraindicated in patients with sulfa allergies.
Hypertensive Retinopathy Findings - Answer ✔✔ - - silver wire/copper wire arterioles.
- AV nicking
VERSION QUESTIONS AND CORRECT DETAILED
ANSWERS |ALREADYGRADED A+
Therapeutic INR values below ____ increase stroke risk sixfold. - Answer ✔✔ - 2
Diabetic Retinopathy Findings - Answer ✔✔ - Microaneurysms
Neovascularization
Cotton Wool Spots
Hard exudates
All of the following would require the nurse practitioner to delay testing a patient's
prostate-specific antigen (PSA), except:
a. Urinary retention
b. Urinary tract infection
c. After a digital rectal exam
d. Vigorous exercise 3 days prior - Answer ✔✔ - Vigorous exercise 3 days prior
PSA testing is falsely elevated in a patient with urinary retention and urinary tract infection
and after a digital rectal exam. Vigorous exercise does not have to be stopped 3 days prior
to testing; however, vigorous exercise should be discouraged before testing because it will
falsely elevate the PSA levels. Ejaculation within 48 hours will also falsely raise the PSA
level.
Tic Douloureaux - Answer ✔✔ - There are two types of tic douloureux (trigeminal
neuralgia).
,Type 1--presents with extreme, shock-like facial pain, which lasts from a few seconds to 2
minutes per event and can last up to 2 hours total. Type 1 does not awaken the patient at
night.
Type 2-- is a constant, aching, burning facial pain with less intensity but may occur with
Type 1. Type 2 is more common in women and peaks in their 60s. Type 2 can also be
related to secondary neurologic disease such as multiple sclerosis or HSV-1.
The nurse practitioner sees a 58-year-old female patient who reports abscesses and
pustules in the axilla and groin and under the breasts, which burst and drain purulent
green discharge. She has a history of smoking and a body mass index (BMI) of 37.1.
Which diagnosis is most likely?
a. Impetigo
b. Carbuncles
c. Shingles
d. Hidradenitis suppurativa - Answer ✔✔ - hidradenitis suppurativa
Hidradenitis suppurativa is most common in women (3:1). Smoking and obesity are
significant risk factors. Lesions are treated with topical antibiotics (or oral antibiotics,
warm compresses, and pain medications). Institute diet changes to reduce high glycemic
and dairy food intake. Refer to a dermatologist for additional treatment options.
Insulin Lispro (Humalog) - Answer ✔✔ - Lispro is a rapid-acting insulin that is used on a
sliding scale to work from meal to meal
Atopic dermatitis (eczema) - Answer ✔✔ - chronic, pruritic rash of the hands, flexural
folds, and neck that can be exacerbated by stress and environmental factors.
,Toxic Epidermal Necrolysis (TEN) - Answer ✔✔ - TEN is the result of a severe skin
reaction to medications such as allopurinol, nonsteroidal anti-inflammatory drugs
(NSAIDs), and anticonvulsants.
Melanoma - Answer ✔✔ - Melanoma are nevi with uneven texture, irregular borders,
variegated colors, size larger than 6 mm, and changing size (the mnemonic ABCDE stands
for asymmetry, border irregularity, color variations in the same region, diameter >6 mm,
and enlargement or change in size over time), and they can be pruritic. Risk factors include
family history of melanoma (10% of cases), extensive/intense sunlight exposure, blistering
sunburn in childhood, tanning beds, and atypical nevus
Seborrheic keratoses - Answer ✔✔ - Seborrheic keratoses are soft, fleshy, painless
growths that are located mostly on the back. Skin lesions look like they are "pasted" on the
skin and can range in color from light tan to black.
Acanthosis nigricans - Answer ✔✔ - Acanthosis nigricans are diffuse, soft thickenings of
the skin usually located at the neck and axilla. They are also associated with diabetes,
metabolic syndrome, obesity, and gastrointestinal cancer.
Acrochordon - Answer ✔✔ - Acrochordons (skin tags) are painless, pedunculated
outgrowths of skin that are common in the neck and axillary areas. If the growths are
traumatized, they become necrotic and fall off. They are most common in diabetics and
patients who are obese.
Which of the following is associated with male aging?
a. Increased levels of estrogen
b. Decreased sperm production
c. Increased production of semen
, d. Decreased concentration of sperm - Answer ✔✔ - Decreased sperm production
A nurse practitioner sees a patient for an evaluation of sexually transmitted diseases.
Assessment reveals Fitz-Hugh-Curtis. The nurse practitioner will prescribe: - Answer ✔✔ -
Ceftriaxone 500 mg IM × one dose plus doxycycline 100 mg BID × 14 days plus
metronidazole 500 mg BID × 14 days.
Fitz-Hugh-Curtis syndrome should be treated as a complicated gonorrheal/chlamydial
infection: Ceftriaxone 500 mg IM × one dose plus doxycycline 100 mg BID × 14 days plus
metronidazole 500 mg BID × 14 days for anaerobic coverage.
sensitive screening test for HIV - Answer ✔✔ - Combination HIV-1 and HIV-2 antibody
immunoassay with p24 antigen.
DM medication class that should not be used in patients with heart failure or hx of bladder
cancer? - Answer ✔✔ - Thiazolidinediones
Medication class with high risk of hypoglycemic events: - Answer ✔✔ - Sulfonylureas
stimulate the beta cells but have a long half-life, and there is a high risk for severe
hypoglycemic events.
Treponema pallidum - Answer ✔✔ - T. pallidum is a gram-negative spirochete bacterium
that causes syphilis.
Which class of diuretics is contraindicated in patients who are allergic to sulfa products? -
Answer ✔✔ - Thiazides (hydrochlorothiazide and indapamide) and loop diuretics
(furosemide and bumetanide) are contraindicated in patients with sulfa allergies.
Hypertensive Retinopathy Findings - Answer ✔✔ - - silver wire/copper wire arterioles.
- AV nicking
