AANP Practice Questions
A 2-year-old male presents for reevaluation. Two days in the past, he had four episodes of
vomiting and 6 diarrheal stools. On physical examination nowadays, his essential signs
monitor P = a hundred and twenty and capillary replenish of 3 seconds. The patient's eyes
are sunken and his extremities are mottled and cool to the touch. The remedy plan would
encompass:
1. Begin oral electrolyte mixture every hour.
2. Hospitalization for IV fluid replacement.
Three. Giving the kid loperamide for each diarrheal stool.
4. Catheterizing the child to gain correct urine output. - ANS-hospitalization for IV fluid
alternative
A 3-yr-old girl has been diagnosed with bacterial meningitis. She attends preschool daily at a
local church day care application. The day before her analysis, she ate lunch together with
her mom at a local restaurant. For which touch(s) could chemoprophylaxis with rifampin be
endorsed?
1. Preschool contacts in the beyond 7 days
2. A pal of the affected person's sister who visited after faculty the day past
3. The checkout worker on the grocery save the previous day
4. Diners on the restaurant throughout lunch the day the patient ate there - ANS-preschool
contacts in beyond 7 days
A 3-year-old affords with a 2-day history of acute diarrhea with a total of eight watery stools
without blood or mucus, and a pair of episodes of vomiting in the past 48 hours. Assessment
reveals no cutting-edge antibiotic remedy, dehydration <five%, tender abdomen with
hyperactive bowel sounds, no masses or organomegaly; different bodily findings are regular.
Which of the subsequent is the most appropriate control plan?
1. Stool way of life; Immodium AD liquid.
2. No laboratory workup; educate dad and mom on signs and symptoms of dehydration;
weight-reduction plan of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup.
3. Start weight-reduction plan of clear beverages, advancing to bananas, rice cereal, Jell-O,
and soup over subsequent seventy two hours; Imodium AD liquid, 1 mg/sml
four. Stool for ova and parasites; propose dad and mom of probable sources of Giardia;
prescribe furazolidone (Furoxone) - ANS-No laboratory workup; educate parents on signs
and symptoms and signs of dehydration; eating regimen of clear drinks, advancing to
bananas, rice cereal, Jell-O, and soup.
A 7-year-antique infant offers with group A streptococcal contamination confirmed by means
of throat culture. Past history consists of treatment for high-quality streptococcal
,contamination with erythromycin (EryPed oral suspension) 3 weeks in the past. What is the
maximum suitable next intervention?
1. Treat with amoxicillin for 10 days.
2. Obtain subculture for all household participants.
3. Treat with azithromycin (Zithromax) for 10 days.
4. Intramuscular Penicillin. - ANS-treat with amoxicillin for 10 days
A 12-12 months-vintage with sickle mobile anemia has these days experienced a sickle
mobile crisis and offers for a comply with-up exam after a recent hospitalization. It is most
important to preserve tracking boom, improvement, and:
1. White blood mobile tiers.
2. Fecal occult blood test.
Three. Hemoglobin tiers.
Four. Urine dipsticks. - ANS-hemoglobin stages
A 13-12 months-old is involved due to the fact she has now not but started to menstruate.
Physical examination indicates that the patient is at Tanner level IV and is of common top
and weight. Which of the subsequent will be the maximum appropriate reaction to this
affected person?
1. "We'll want to refer you to an endocrinologist for an entire workup."
2. "We'll need to perform a little tests to discover why you aren't having periods."
3. "I'll provide you with a few capsules a good way to make your durations start."
four. "Your improvement is precisely as predicted for your age; you may in all likelihood
begin to have periods inside a 12 months." - ANS-"Your improvement is exactly as expected
for your age; you will in all likelihood start to have periods within a yr."
A 16-year-old female adolescent is added to the nurse practitioner's office with the aid of her
mom, who's worried about her daughter's latest weight reduction. History famous that the
daughter was constantly in the 50th percentile for weight, however is now inside the tenth
percentile. The mother states that she is concerned that her daughter is purging herself after
food seeing that she often is going to the restroom after ingesting and stays there for a long
time period. The daughter denies any self-brought about vomiting, hunger or excessive
interest. She does state that she jogs 5 miles a day and is in appropriate condition. In
addition to a complete blood depend with differential, which of the subsequent laboratory
assessments may be maximum useful for in addition evaluation?
1. Electrolytes, fasting blood sugar
2. Creatine phosphokinase, follicle-stimulating hormone (FSH)
three. Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis
4. Electrolyt - ANS-electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis
A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and omeprazole
(Prilosec). The affected person complains of headache, abdominal ache, and fuel. These
signs are most possibly:
,1. Associated with the omeprazole.
2. Related to the underlying condition.
3. The result of the NSAID.
4. Resulting from viral gastroenteritis. - ANS-related to the omeprazole
A 19-12 months-vintage patient who has used oral contraceptives for three years plans to
discontinue the tablet on the end of her present day cycle to turn out to be pregnant. Which
of the following daily supplements might receive the highest precedence?
1. Calcium carbonate
2. Folic acid
3. Ferrous sulfate
four. Multivitamin - ANS-folic acid
A 26-yr-antique lady provides with stomach distention, bloating, and intermittent crampy
belly ache relieved by defecation. She has four to 6 unfastened stools an afternoon whilst
stressed. Between bouts of diarrhea, she often has constipation. Physical examination
results are ordinary. The CBC become everyday. The maximum likely diagnosis is:
1. Diverticulitis.
2. Viral gastroenteritis.
3. Inflammatory bowel disease.
Four. Irritable bowel syndrome - ANS-irritable bowel syndrome
A 27-12 months-vintage male affected person, who works as a janitor, gives with a 6-month
records of an intermittent rash on his arms. History well-knownshows itching and low
burning. Examination famous irregularly-dispensed scaly maculopapular erythematous
patches extending from the dorsum of the hand several inches up the forearms, and dry
fingers and not using a nail involvement. The most probable prognosis is:
1. Touch dermatitis.
2. Scabies infestation.
3. Psoriasis.
Four. Eczema. - ANS-touch dermatitis
A 28-12 months-vintage affected person provides with profuse yellow vaginal discharge,
odor, and neighborhood irritation. She reviews completing a 7-day path of oral metronidazole
(Flagyl), 500 mg b.I.D. 4 weeks ago. She has had multiple recurrences over the past 18
months. Microscopic exam exhibits presence of clue cells. What is the maximum appropriate
remedy 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
three. Metronidazole vaginal gel (MetroGel) twice weekly for 4 to six months
, 4. Treat affected person with metronidazole vaginal gel (MetroGel) b.I.D. And companion(s)
with tetracycline, 250 mg q.I.D., for 7 days - ANS-Treat each patient and accomplice(s) with
oral metronidazole (Flagyl), 500 mg b.I.D., for 7 days
A 30-month-old with a records of common ear infections changed into seen in September
after a symptom-free summer time. Examination revealed bilateral bulging eardrums. After
two separate publications of antibiotics, fluid is referred to in each ears. The parent reviews
speech difficulties. The most probable prognosis is:
1. Otitis media with effusion.
2. Myringitis.
Three. Recurrent acute otitis.
Four. Esutachian tube disorder. - ANS-otiti media with effusion
A 46-yr-vintage girl discovered a lump in her breast this morning. History includes: no prior
breast disease; G2P2 (first start, age 22); maternal aunt recognized with breast cancer at
age seventy two; remaining menstrual length was 2.5 weeks in the past. On exam, a nurse
practitioner palpates a 2-cm round, gentle, cell, tender lesion within the upper outer quadrant
of the right breast. Mammogram is bad. Which of the subsequent actions is maximum
suitable?
1. Reassure the patient that no in addition motion is necessary.
2. Repeat unilateral proper mammogram in three months.
Three. Schedule a proper-breast ultrasound.
4. Refer for genetic testing if the lump increases in length. - ANS-agenda a right breast
ultrasound
A forty six-12 months-vintage woman presents with a criticism of amenorrhea for 3 months.
The first-line diagnostic workup is:
1. Urine pregnancy check.
2. Progesterone project.
3. Serum prolactin degree.
4. Thyroid-stimulating hormone (TSH). - ANS-urine being pregnant take a look at
A 50-12 months-old male gives 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 reviews
wellknown emotions of depression, forgetfulness, and, regardless of the reality that he is
often hired, a mounting series of unpaid and overdue payments. In taking the affected
person's history, a substantial pattern of parental alcohol abuse, stroke, TIA, and MI
emerges. During wondering to elicit a greater thorough diagnosis, the patient will become
adverse and leaves the hospital without similarly remedy. The most possibly reason for this
behavior is:
1. Alzheimer's disease.
2. Chronic alcoholism.
Three. Most cancers.
Four. Carotid artery stenosis. - ANS-continual alcoholism
A 2-year-old male presents for reevaluation. Two days in the past, he had four episodes of
vomiting and 6 diarrheal stools. On physical examination nowadays, his essential signs
monitor P = a hundred and twenty and capillary replenish of 3 seconds. The patient's eyes
are sunken and his extremities are mottled and cool to the touch. The remedy plan would
encompass:
1. Begin oral electrolyte mixture every hour.
2. Hospitalization for IV fluid replacement.
Three. Giving the kid loperamide for each diarrheal stool.
4. Catheterizing the child to gain correct urine output. - ANS-hospitalization for IV fluid
alternative
A 3-yr-old girl has been diagnosed with bacterial meningitis. She attends preschool daily at a
local church day care application. The day before her analysis, she ate lunch together with
her mom at a local restaurant. For which touch(s) could chemoprophylaxis with rifampin be
endorsed?
1. Preschool contacts in the beyond 7 days
2. A pal of the affected person's sister who visited after faculty the day past
3. The checkout worker on the grocery save the previous day
4. Diners on the restaurant throughout lunch the day the patient ate there - ANS-preschool
contacts in beyond 7 days
A 3-year-old affords with a 2-day history of acute diarrhea with a total of eight watery stools
without blood or mucus, and a pair of episodes of vomiting in the past 48 hours. Assessment
reveals no cutting-edge antibiotic remedy, dehydration <five%, tender abdomen with
hyperactive bowel sounds, no masses or organomegaly; different bodily findings are regular.
Which of the subsequent is the most appropriate control plan?
1. Stool way of life; Immodium AD liquid.
2. No laboratory workup; educate dad and mom on signs and symptoms of dehydration;
weight-reduction plan of clear liquids, advancing to bananas, rice cereal, Jell-O, and soup.
3. Start weight-reduction plan of clear beverages, advancing to bananas, rice cereal, Jell-O,
and soup over subsequent seventy two hours; Imodium AD liquid, 1 mg/sml
four. Stool for ova and parasites; propose dad and mom of probable sources of Giardia;
prescribe furazolidone (Furoxone) - ANS-No laboratory workup; educate parents on signs
and symptoms and signs of dehydration; eating regimen of clear drinks, advancing to
bananas, rice cereal, Jell-O, and soup.
A 7-year-antique infant offers with group A streptococcal contamination confirmed by means
of throat culture. Past history consists of treatment for high-quality streptococcal
,contamination with erythromycin (EryPed oral suspension) 3 weeks in the past. What is the
maximum suitable next intervention?
1. Treat with amoxicillin for 10 days.
2. Obtain subculture for all household participants.
3. Treat with azithromycin (Zithromax) for 10 days.
4. Intramuscular Penicillin. - ANS-treat with amoxicillin for 10 days
A 12-12 months-vintage with sickle mobile anemia has these days experienced a sickle
mobile crisis and offers for a comply with-up exam after a recent hospitalization. It is most
important to preserve tracking boom, improvement, and:
1. White blood mobile tiers.
2. Fecal occult blood test.
Three. Hemoglobin tiers.
Four. Urine dipsticks. - ANS-hemoglobin stages
A 13-12 months-old is involved due to the fact she has now not but started to menstruate.
Physical examination indicates that the patient is at Tanner level IV and is of common top
and weight. Which of the subsequent will be the maximum appropriate reaction to this
affected person?
1. "We'll want to refer you to an endocrinologist for an entire workup."
2. "We'll need to perform a little tests to discover why you aren't having periods."
3. "I'll provide you with a few capsules a good way to make your durations start."
four. "Your improvement is precisely as predicted for your age; you may in all likelihood
begin to have periods inside a 12 months." - ANS-"Your improvement is exactly as expected
for your age; you will in all likelihood start to have periods within a yr."
A 16-year-old female adolescent is added to the nurse practitioner's office with the aid of her
mom, who's worried about her daughter's latest weight reduction. History famous that the
daughter was constantly in the 50th percentile for weight, however is now inside the tenth
percentile. The mother states that she is concerned that her daughter is purging herself after
food seeing that she often is going to the restroom after ingesting and stays there for a long
time period. The daughter denies any self-brought about vomiting, hunger or excessive
interest. She does state that she jogs 5 miles a day and is in appropriate condition. In
addition to a complete blood depend with differential, which of the subsequent laboratory
assessments may be maximum useful for in addition evaluation?
1. Electrolytes, fasting blood sugar
2. Creatine phosphokinase, follicle-stimulating hormone (FSH)
three. Electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis
4. Electrolyt - ANS-electrolytes, blood urea nitrogen (BUN)/creatinine, urinalysis
A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and omeprazole
(Prilosec). The affected person complains of headache, abdominal ache, and fuel. These
signs are most possibly:
,1. Associated with the omeprazole.
2. Related to the underlying condition.
3. The result of the NSAID.
4. Resulting from viral gastroenteritis. - ANS-related to the omeprazole
A 19-12 months-vintage patient who has used oral contraceptives for three years plans to
discontinue the tablet on the end of her present day cycle to turn out to be pregnant. Which
of the following daily supplements might receive the highest precedence?
1. Calcium carbonate
2. Folic acid
3. Ferrous sulfate
four. Multivitamin - ANS-folic acid
A 26-yr-antique lady provides with stomach distention, bloating, and intermittent crampy
belly ache relieved by defecation. She has four to 6 unfastened stools an afternoon whilst
stressed. Between bouts of diarrhea, she often has constipation. Physical examination
results are ordinary. The CBC become everyday. The maximum likely diagnosis is:
1. Diverticulitis.
2. Viral gastroenteritis.
3. Inflammatory bowel disease.
Four. Irritable bowel syndrome - ANS-irritable bowel syndrome
A 27-12 months-vintage male affected person, who works as a janitor, gives with a 6-month
records of an intermittent rash on his arms. History well-knownshows itching and low
burning. Examination famous irregularly-dispensed scaly maculopapular erythematous
patches extending from the dorsum of the hand several inches up the forearms, and dry
fingers and not using a nail involvement. The most probable prognosis is:
1. Touch dermatitis.
2. Scabies infestation.
3. Psoriasis.
Four. Eczema. - ANS-touch dermatitis
A 28-12 months-vintage affected person provides with profuse yellow vaginal discharge,
odor, and neighborhood irritation. She reviews completing a 7-day path of oral metronidazole
(Flagyl), 500 mg b.I.D. 4 weeks ago. She has had multiple recurrences over the past 18
months. Microscopic exam exhibits presence of clue cells. What is the maximum appropriate
remedy 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
three. Metronidazole vaginal gel (MetroGel) twice weekly for 4 to six months
, 4. Treat affected person with metronidazole vaginal gel (MetroGel) b.I.D. And companion(s)
with tetracycline, 250 mg q.I.D., for 7 days - ANS-Treat each patient and accomplice(s) with
oral metronidazole (Flagyl), 500 mg b.I.D., for 7 days
A 30-month-old with a records of common ear infections changed into seen in September
after a symptom-free summer time. Examination revealed bilateral bulging eardrums. After
two separate publications of antibiotics, fluid is referred to in each ears. The parent reviews
speech difficulties. The most probable prognosis is:
1. Otitis media with effusion.
2. Myringitis.
Three. Recurrent acute otitis.
Four. Esutachian tube disorder. - ANS-otiti media with effusion
A 46-yr-vintage girl discovered a lump in her breast this morning. History includes: no prior
breast disease; G2P2 (first start, age 22); maternal aunt recognized with breast cancer at
age seventy two; remaining menstrual length was 2.5 weeks in the past. On exam, a nurse
practitioner palpates a 2-cm round, gentle, cell, tender lesion within the upper outer quadrant
of the right breast. Mammogram is bad. Which of the subsequent actions is maximum
suitable?
1. Reassure the patient that no in addition motion is necessary.
2. Repeat unilateral proper mammogram in three months.
Three. Schedule a proper-breast ultrasound.
4. Refer for genetic testing if the lump increases in length. - ANS-agenda a right breast
ultrasound
A forty six-12 months-vintage woman presents with a criticism of amenorrhea for 3 months.
The first-line diagnostic workup is:
1. Urine pregnancy check.
2. Progesterone project.
3. Serum prolactin degree.
4. Thyroid-stimulating hormone (TSH). - ANS-urine being pregnant take a look at
A 50-12 months-old male gives 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 reviews
wellknown emotions of depression, forgetfulness, and, regardless of the reality that he is
often hired, a mounting series of unpaid and overdue payments. In taking the affected
person's history, a substantial pattern of parental alcohol abuse, stroke, TIA, and MI
emerges. During wondering to elicit a greater thorough diagnosis, the patient will become
adverse and leaves the hospital without similarly remedy. The most possibly reason for this
behavior is:
1. Alzheimer's disease.
2. Chronic alcoholism.
Three. Most cancers.
Four. Carotid artery stenosis. - ANS-continual alcoholism
