ANCC TESTED QUESTIONS AND
COMPLETE SOLUTIONS
◉ An 84-year-old patient arrives at the office for an initial visit.
The patient questions the need for colorectal screening, since 10
years have passed since the last colonoscopy. The adult-
gerontology primary care nurse practitioner recommends:
(a) a colonoscopy.
(b) a fecal DNA test.
(c) flexible sigmoidoscopy.
(d) watchful waiting.
Answer: (d) watchful waiting.
◉ To evaluate for heart failure, which diagnostic test does the
adult-gerontology primary care nurse practitioner order for a
patient with swelling in the lower extremities?
(a) Ankle-brachial index.
(b) Brain natriuretic peptide test.
(c) D-dimer assay.
(d) Spirometry study.
Answer: (b) Brain natriuretic peptide test.
,◉ Before placing a patient with onychomycosis on a pulsed dose
of itraconazole (Sporanox), which laboratory values does the
adult-gerontology primary care nurse practitioner obtain?
(a) Liver function studies.
(b) Platelet count.
(c) Renal function studies.
(d) White blood cell count.
Answer: (a) Liver function studies.
◉ A 30-year-old, female patient has a two-week history of nausea,
vomiting, decreased weight, abdominal pain, and a long-term
history of multiple sexual partners. The patient's physical
examination reveals abdominal tenderness with icteric sclerae
and skin. Which laboratory test confirms active hepatitis B?
(a) Antibody.
(b) Enzyme-linked immunosorbent assay.
(c) Immune globulin G.
(d) Surface antigen.
Answer: (d) Surface antigen.
,◉ For two to three months, a 78-year-old patient has not been
taking levothyroxine (Synthroid) as prescribed. The patient now
has symptoms of increasing constipation, lethargy, and weakness.
The adult-gerontology primary care nurse practitioner anticipates
that laboratory tests will show that the patient's:
(a) T4 level decreased, and TSH level increased.
(b) T4 level increased, and TSH level decreased.
(c) T4 level increased, and TSH level is unchanged.
(d) T4 level is unchanged, and TSH level decreased.
Answer: (a) T4 level decreased, and TSH level increased.
◉ A 68-year-old patient has sustained an unintended weight loss
of 15 lb (6.8 kg) over the last two months but reports feeling well.
The patient's problems include depression, tobacco abuse,
obesity, and dyslipidemia. His or her medications are sertralizine
(Zoloft), simvastatin (Zocor), and famotidine (Pepcid). The adult-
gerontology primary care nurse practitioner performs which
THREE actions?
(a) Adds a probiotic.
(b) Conducts a depression screening.
, (c) Decreases the dosage of the statin medication.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.
Answer: (b) Conducts a depression screening.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.
◉ Preparing to implement an incontinence reduction program at
a nursing home, the adult-gerontology primary care nurse
practitioner reviews several studies. Place the studies in
sequential order of the strength of evidence for this population
from strongest to weakest.
(a) A case report of an experimental incontinence reduction
program in older adults.
(b) A consensus statement from the urologic association
regarding the use of scheduled toileting.
COMPLETE SOLUTIONS
◉ An 84-year-old patient arrives at the office for an initial visit.
The patient questions the need for colorectal screening, since 10
years have passed since the last colonoscopy. The adult-
gerontology primary care nurse practitioner recommends:
(a) a colonoscopy.
(b) a fecal DNA test.
(c) flexible sigmoidoscopy.
(d) watchful waiting.
Answer: (d) watchful waiting.
◉ To evaluate for heart failure, which diagnostic test does the
adult-gerontology primary care nurse practitioner order for a
patient with swelling in the lower extremities?
(a) Ankle-brachial index.
(b) Brain natriuretic peptide test.
(c) D-dimer assay.
(d) Spirometry study.
Answer: (b) Brain natriuretic peptide test.
,◉ Before placing a patient with onychomycosis on a pulsed dose
of itraconazole (Sporanox), which laboratory values does the
adult-gerontology primary care nurse practitioner obtain?
(a) Liver function studies.
(b) Platelet count.
(c) Renal function studies.
(d) White blood cell count.
Answer: (a) Liver function studies.
◉ A 30-year-old, female patient has a two-week history of nausea,
vomiting, decreased weight, abdominal pain, and a long-term
history of multiple sexual partners. The patient's physical
examination reveals abdominal tenderness with icteric sclerae
and skin. Which laboratory test confirms active hepatitis B?
(a) Antibody.
(b) Enzyme-linked immunosorbent assay.
(c) Immune globulin G.
(d) Surface antigen.
Answer: (d) Surface antigen.
,◉ For two to three months, a 78-year-old patient has not been
taking levothyroxine (Synthroid) as prescribed. The patient now
has symptoms of increasing constipation, lethargy, and weakness.
The adult-gerontology primary care nurse practitioner anticipates
that laboratory tests will show that the patient's:
(a) T4 level decreased, and TSH level increased.
(b) T4 level increased, and TSH level decreased.
(c) T4 level increased, and TSH level is unchanged.
(d) T4 level is unchanged, and TSH level decreased.
Answer: (a) T4 level decreased, and TSH level increased.
◉ A 68-year-old patient has sustained an unintended weight loss
of 15 lb (6.8 kg) over the last two months but reports feeling well.
The patient's problems include depression, tobacco abuse,
obesity, and dyslipidemia. His or her medications are sertralizine
(Zoloft), simvastatin (Zocor), and famotidine (Pepcid). The adult-
gerontology primary care nurse practitioner performs which
THREE actions?
(a) Adds a probiotic.
(b) Conducts a depression screening.
, (c) Decreases the dosage of the statin medication.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.
Answer: (b) Conducts a depression screening.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.
◉ Preparing to implement an incontinence reduction program at
a nursing home, the adult-gerontology primary care nurse
practitioner reviews several studies. Place the studies in
sequential order of the strength of evidence for this population
from strongest to weakest.
(a) A case report of an experimental incontinence reduction
program in older adults.
(b) A consensus statement from the urologic association
regarding the use of scheduled toileting.
