AANP Test 2 for Boards
A 28-year-old female patient is in the office and is to undergo radioactive iodine treatment for
Graves disease. The ANP is counseling her and understands that the mechanism of action of
this treatment therapy is:
alter the thyroid metabolic rate
relieve distress caused by increased thyroid size
destroy the overactive thyroid tissue
reduce production of TSH - ANS-Correct answer:
destroy the overactive thyroid tissue
Graves disease is the most common form of thyrotoxicosis. Radioactive iodine is used for
thyroid ablation to destroy the overactive thyroid tissue that causes thyroid hormone
dysfunction.
\A 29-year old woman who is 6 weeks postpartum reports she is having rectal bleeding that she
believes is related to hemorrhoids. The Adult Nurse Practitioner knows that this type of rectal
bleeding is usually described as:
dark brown to black blood color with normal-appearing stool
significant amounts of bright red blood
large blood clots and mucus mixed with stool
streaks of bright red blood on the stool - ANS-The Correct answer is:
streaks of bright red blood on the stool
Choice D is the right answer. The color of blood related to hemorrhoids is described as bright
red, eliminating choice A. Amount of blood with hemorrhoids is usually small or scant,
eliminating choices B and C. Internal hemorrhoids can occur during or after childbirth. With
chronically protruding or prolapsing hemorrhoids, the patient often reports mucous leaking and
staining of the undergarments. Other causes are obesity, constipation, and prolonged sitting.
\A 48-year-old male patient complains of a sudden onset of severe "ice pick" pains behind one
eye. He tells you that the headache is accompanied by tearing, a clear runny nasal discharge,
and a drooping eyelid. What type of headache would you diagnose?
muscle tension headache
cluster headache
migraine headache
temporal arteritis - ANS-Correct answer:
cluster headache
,Cluster headaches are severe headaches with lancinating pain behind one eye that occurs
several times a day, usually at the same times every day. Their cause is unknown and they are
more common in adult males in their 30s and 40s.
\A 65-year-old Caucasian female is in the office with rosacea. She is asking about treatment
options. What is the recommended treatment for her?
topical 5-fluorouracil
low-dose tetracycline
oral ketoconazole
oral hydrocortisone - ANS-Correct Answer:
low-dose tetracycline
Treatment with systemic low-dose tetracycline is a very effective measure for rosacea; topical
treatment with metronidazole or a low-dose steroid cream may also be helpful. Topical
5-fluorouracil is used to treat actinic keratosis.
\A 66-year-old male patient has been diagnosed with Parkinson's disease. You understand that
the disease varies from person to person but that the signs and symptoms include all but which
of the following?
pill-rolling tremor
akathisia
muscular rigidity with masked facies
cog-wheel rigidity - ANS-Correct answer:
akathisia
Akathisia is a movement disorder that is characterized by a feeling of inner restlessness and a
need to be in constant motion. Bradykinesia, on the other hand, is a reduction in the ability to
initiate voluntary movement which is typical in Parkinson's patients. Cog-wheel rigidity and
muscular rigidity with masked facies as well as pill rolling tremors are all symptoms of Parkinson
disease.
\A 67 year female patient has been diagnosed with chronic obstructive pulmonary disease. Her
arterial blood gases were measured. Partial pressure of oxygen in arterial blood (PaO2)
declines with normal aging. What PaO2 level indicates chronic hypoxemia?
<55 mm Hg.
<65 mm Hg.
< 75 mm Hg.
Presence of aphasia, apraxia, agnosia and/or disturbance of executive function. - ANS-Correct
Answer:
<55 mm Hg.
, A PaO2 level <55 mm Hg indicates chronic hypoxemia. A patient with this measurement will
require continuous oxygen therapy.
\A 68-year-old woman has been admitted to the hospital suffering from peripheral vascular
disease (PVD). You check her medical records for predisposing factors. You recognize that all of
the following are predisposing factors EXCEPT:
arteriosclerosis
advanced age
a history of renal problems
valvular incompetence - ANS-Correct answer:
a history of renal problems
A predisposing factor for PVD is a history of deep vein thrombosis (DVT). All of the other
choices are valid predisposing factors.
\A brief account by the patient of any signs or symptoms he or she is experiencing is one
component of:
Review of systems.
Symptom assessment.
Functional assessment.
Objective assessment. - ANS-Correct Answer:
Review of systems
In the review of systems, the patient tells the nurse in his or her own words what signs or
symptoms he or she has experienced in various body systems. It is important that these be in a
patient's own words to perform the most complete and accurate assessment.
\A cancer in which there is extensive local and regional spread is in which stage?
Stage I
Stage II
Stage III
Stage IV - ANS-Correct answer:
Stage III
Staging classifies the clinical aspects of the cancer and the degree of metastasis at diagnosis. A
cancer with extensive local and regional spread is a Stage III cancer.
\A geriatric patient with cardiovascular disease is in the office being counseled on lifestyle
changes. The ANP knows that which of the following is the most important to include in this
discussion?
"Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly."
"Have a yearly physical examination, increase fiber in your diet, and exercise regularly."
"Maintain a normal level of serum blood sugar and decrease cholesterol intake."
A 28-year-old female patient is in the office and is to undergo radioactive iodine treatment for
Graves disease. The ANP is counseling her and understands that the mechanism of action of
this treatment therapy is:
alter the thyroid metabolic rate
relieve distress caused by increased thyroid size
destroy the overactive thyroid tissue
reduce production of TSH - ANS-Correct answer:
destroy the overactive thyroid tissue
Graves disease is the most common form of thyrotoxicosis. Radioactive iodine is used for
thyroid ablation to destroy the overactive thyroid tissue that causes thyroid hormone
dysfunction.
\A 29-year old woman who is 6 weeks postpartum reports she is having rectal bleeding that she
believes is related to hemorrhoids. The Adult Nurse Practitioner knows that this type of rectal
bleeding is usually described as:
dark brown to black blood color with normal-appearing stool
significant amounts of bright red blood
large blood clots and mucus mixed with stool
streaks of bright red blood on the stool - ANS-The Correct answer is:
streaks of bright red blood on the stool
Choice D is the right answer. The color of blood related to hemorrhoids is described as bright
red, eliminating choice A. Amount of blood with hemorrhoids is usually small or scant,
eliminating choices B and C. Internal hemorrhoids can occur during or after childbirth. With
chronically protruding or prolapsing hemorrhoids, the patient often reports mucous leaking and
staining of the undergarments. Other causes are obesity, constipation, and prolonged sitting.
\A 48-year-old male patient complains of a sudden onset of severe "ice pick" pains behind one
eye. He tells you that the headache is accompanied by tearing, a clear runny nasal discharge,
and a drooping eyelid. What type of headache would you diagnose?
muscle tension headache
cluster headache
migraine headache
temporal arteritis - ANS-Correct answer:
cluster headache
,Cluster headaches are severe headaches with lancinating pain behind one eye that occurs
several times a day, usually at the same times every day. Their cause is unknown and they are
more common in adult males in their 30s and 40s.
\A 65-year-old Caucasian female is in the office with rosacea. She is asking about treatment
options. What is the recommended treatment for her?
topical 5-fluorouracil
low-dose tetracycline
oral ketoconazole
oral hydrocortisone - ANS-Correct Answer:
low-dose tetracycline
Treatment with systemic low-dose tetracycline is a very effective measure for rosacea; topical
treatment with metronidazole or a low-dose steroid cream may also be helpful. Topical
5-fluorouracil is used to treat actinic keratosis.
\A 66-year-old male patient has been diagnosed with Parkinson's disease. You understand that
the disease varies from person to person but that the signs and symptoms include all but which
of the following?
pill-rolling tremor
akathisia
muscular rigidity with masked facies
cog-wheel rigidity - ANS-Correct answer:
akathisia
Akathisia is a movement disorder that is characterized by a feeling of inner restlessness and a
need to be in constant motion. Bradykinesia, on the other hand, is a reduction in the ability to
initiate voluntary movement which is typical in Parkinson's patients. Cog-wheel rigidity and
muscular rigidity with masked facies as well as pill rolling tremors are all symptoms of Parkinson
disease.
\A 67 year female patient has been diagnosed with chronic obstructive pulmonary disease. Her
arterial blood gases were measured. Partial pressure of oxygen in arterial blood (PaO2)
declines with normal aging. What PaO2 level indicates chronic hypoxemia?
<55 mm Hg.
<65 mm Hg.
< 75 mm Hg.
Presence of aphasia, apraxia, agnosia and/or disturbance of executive function. - ANS-Correct
Answer:
<55 mm Hg.
, A PaO2 level <55 mm Hg indicates chronic hypoxemia. A patient with this measurement will
require continuous oxygen therapy.
\A 68-year-old woman has been admitted to the hospital suffering from peripheral vascular
disease (PVD). You check her medical records for predisposing factors. You recognize that all of
the following are predisposing factors EXCEPT:
arteriosclerosis
advanced age
a history of renal problems
valvular incompetence - ANS-Correct answer:
a history of renal problems
A predisposing factor for PVD is a history of deep vein thrombosis (DVT). All of the other
choices are valid predisposing factors.
\A brief account by the patient of any signs or symptoms he or she is experiencing is one
component of:
Review of systems.
Symptom assessment.
Functional assessment.
Objective assessment. - ANS-Correct Answer:
Review of systems
In the review of systems, the patient tells the nurse in his or her own words what signs or
symptoms he or she has experienced in various body systems. It is important that these be in a
patient's own words to perform the most complete and accurate assessment.
\A cancer in which there is extensive local and regional spread is in which stage?
Stage I
Stage II
Stage III
Stage IV - ANS-Correct answer:
Stage III
Staging classifies the clinical aspects of the cancer and the degree of metastasis at diagnosis. A
cancer with extensive local and regional spread is a Stage III cancer.
\A geriatric patient with cardiovascular disease is in the office being counseled on lifestyle
changes. The ANP knows that which of the following is the most important to include in this
discussion?
"Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly."
"Have a yearly physical examination, increase fiber in your diet, and exercise regularly."
"Maintain a normal level of serum blood sugar and decrease cholesterol intake."
