AANP Exam
Expected Questions and Answers (Verified Answers)
1. A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which of the
following medications, if being actively consumed, must be immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)
ANS: D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and belongs to a drug
class known as serotonin agonists. When used in conjunction with St. John's wort, it may
increase the risk of serotonin syndrome, a potentially life-threatening condition.
2. Which of the following is not a symptom of both major depressive disorder and post-
traumatic stress disorder?
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57
,A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty
ANS: B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive
disorder (MDD) may also include symptoms of depressed mood, anhedonia, weight loss
or gain, and low energy. However, hypervigilance (B) is not a symptom associ- ated with
this diagnosis.
3. A patient with type 1 diabetes presents for a follow-up visit. He has been stable on
his medication regimen but is worried because he is between jobs and will be without
health insurance coverage for a few months. He asks if there are less expensive insulin
options to get him through this time. Which of the following would be good options for
this patient, given his circumstance? Incorrect
A.
Insulin aspart 70/30
B.
Insulin detemir C.
2/
57
,Insulin isophane
D.
Insulin degludec
ANS: Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral
protamine Hagedorn insulin). There are also often pharmacy-specific coupons that can
be used on insulin, so helping patients apply for and navigate these pro- grams can be
instrumental in managing their diabetes. Another inexpensive option is regular
insulin.Insulin analogs (glargine, detemir, degludec, lispro, and aspart) are significantly
more expensive than human insulin (isophane, regular). Insulins modified by
manufacturers, especially when sold as brand-name medications, tend to be more
expensive due to this modification. While analogs offer alternate lengths of action and
convenience, there is no well-documented clinical evidence that patient outcomes are
improved with differing brands. Therefore, maintaining a patient's blood glucose level
through outcome-focused treatment is more valuable than a process-focused plan based
on medication.
4. A 40-year-old woman with type 2 diabetes presents to the clinic with con- cerns of
spiking blood sugar between lunch and dinner. She states she is on a rapid-acting
insulin sliding scale and long-acting insulin. Which change should be implemented to
help prevent or curb this glycemic spike?
3/
57
, A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
ANS: A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals
and as a sliding scale regimen based on a patient's glucose prior to eating (preprandial). It
is the appropriate insulin to add as a mealtime dose when patients experience blood
glucose spikes between meals because of its short-acting proper-
4/
57
Expected Questions and Answers (Verified Answers)
1. A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which of the
following medications, if being actively consumed, must be immediately stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)
ANS: D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and belongs to a drug
class known as serotonin agonists. When used in conjunction with St. John's wort, it may
increase the risk of serotonin syndrome, a potentially life-threatening condition.
2. Which of the following is not a symptom of both major depressive disorder and post-
traumatic stress disorder?
1/
57
,A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty
ANS: B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major depressive
disorder (MDD) may also include symptoms of depressed mood, anhedonia, weight loss
or gain, and low energy. However, hypervigilance (B) is not a symptom associ- ated with
this diagnosis.
3. A patient with type 1 diabetes presents for a follow-up visit. He has been stable on
his medication regimen but is worried because he is between jobs and will be without
health insurance coverage for a few months. He asks if there are less expensive insulin
options to get him through this time. Which of the following would be good options for
this patient, given his circumstance? Incorrect
A.
Insulin aspart 70/30
B.
Insulin detemir C.
2/
57
,Insulin isophane
D.
Insulin degludec
ANS: Insulin Isophane
The least expensive insulin type listed in this question is insulin isophane (C) (neutral
protamine Hagedorn insulin). There are also often pharmacy-specific coupons that can
be used on insulin, so helping patients apply for and navigate these pro- grams can be
instrumental in managing their diabetes. Another inexpensive option is regular
insulin.Insulin analogs (glargine, detemir, degludec, lispro, and aspart) are significantly
more expensive than human insulin (isophane, regular). Insulins modified by
manufacturers, especially when sold as brand-name medications, tend to be more
expensive due to this modification. While analogs offer alternate lengths of action and
convenience, there is no well-documented clinical evidence that patient outcomes are
improved with differing brands. Therefore, maintaining a patient's blood glucose level
through outcome-focused treatment is more valuable than a process-focused plan based
on medication.
4. A 40-year-old woman with type 2 diabetes presents to the clinic with con- cerns of
spiking blood sugar between lunch and dinner. She states she is on a rapid-acting
insulin sliding scale and long-acting insulin. Which change should be implemented to
help prevent or curb this glycemic spike?
3/
57
, A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
ANS: A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals
and as a sliding scale regimen based on a patient's glucose prior to eating (preprandial). It
is the appropriate insulin to add as a mealtime dose when patients experience blood
glucose spikes between meals because of its short-acting proper-
4/
57
