ANCC Practice Questions
A 14-year-old, male patient has some general concerns about eczema, as his twin brother was recently diagnosed
with this condition. The patient reports urticaria and a rash on his posterior knees bilaterally. The three factors that put
the patient at risk for eczema are a family history of eczema, a personal history of allergic rhinitis, and a history of:
(a) asthma
(b) bee allergy
(c) otitis media
(d) psoriasis - Correct Answer (a) asthma
A 15-year-old patient with type 1 diabetes mellitus reports elevated blood glucose levels in the morning. An adult-
gerontology acute care nurse practitioner determines that the patient's hyperglycemia is due to the dawn
phenomenon and:
(a) increases the insulin dosage at bed time.
(b) reduces the insulin dosage at bed time.
(c) tests the blood glucose level at 3:00 AM every morning.
(d) tests the blood glucose level in the evening. - Correct Answer (a) increases the insulin dosage at bed time.
A 16-year-old patient has been diagnosed with mononucleosis and has a positive throat culture for group Alpha-
hemolytic streptococcal infection. The medication of choice for this patient is:
(a) amoxicillin (Amoxil).
(b) doxycycline (Vibramycin).
(c) erythromycin (E-Mycin).
(d) trimethoprim-sulfamethoxazole (Bactrim). - Correct Answer (c) erythromycin (E-Mycin).
A 19-year-old male patient arrives at the emergency department exhibiting symptoms of lower abdominal pain that
radiates to the groin, and that the patient rates as an 8 on a scale of 1 to 10. That patient states that the pain came on
suddenly, while he was playing football with friends. The patient's physical examination reveals positive bowel sounds
in all quadrants; a soft, non-tender abdomen; no rebounding and no guarding; and no palpable mass in the abdomen
or groin. Examination of the patient's genitalia reveals a unilateral cremasteric reflex. What is the adult-gerontology
acute care nurse practitioner's leading differential diagnosis, based on the patient's presentation?
(a) Appendicitis
(b) Epididymitis
(c) Inguinal hernia
(d) Testicular torsion - Correct Answer (d) Testicular torsion
A 21-year-old patient is admitted to the intensive care unit with a severe closed head injury. The patient's family is
becoming louder and more insistent about seeing the patient. To establish a therapeutic relationship with the family,
an acute care nurse practitioner's initial action is to:
(a) acknowledge the family's anxiety.
(b) arrange for a meeting with a social worker.
(c) escort the family to a conference room.
,(d) gently direct the family to maintain composure. - Correct Answer (a) acknowledge the family's anxiety.
A 24-year-old male patient with a closed head injury has been intubated for 12 days. The patient's parents have
repeatedly refused consent for a tracheostomy and long-term care placement. On multiple occasions, the surgeon
has discussed the risks and benefits of the surgery with them. Addressing the parents, the acute care nurse
practitioner states:
(a) "I understand you have reservations about the placement of a tracheostomy."
(b) "Please know that not many patients die while undergoing a tracheostomy."
(c) "Without a tracheostomy, we can't transfer your son to another facility."
(d) "You know, your son will die if a tracheostomy is not placed." - Correct Answer (a) "I understand you have
reservations about the placement of a tracheostomy."
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. - Correct Answer (d) Surface antigen.
A 32-year-old patient who underwent an open splenectomy for a ruptured spleen, is preparing for discharge. An
adult-gerontology acute care nurse practitioner reviews the potential complications with the patient. The nurse
practitioner emphasizes which instruction to the patient?
(a) Continue antibiotics for 14 days
(b) Follow up with primary care provider for vaccinations
(c) No international travel for five years
(d) No weight lifting restrictions - Correct Answer (b) Follow up with primary care provider for vaccinations
A 34-year-old truck driver reports a sharp pain in the lower back that worsens with ambulation. The symptoms began
after a strenuous three-day driving trip. During an examination, the patient has difficulty walking on the heels and
shows weakness in the extensors of the big toes. The initial differential diagnosis is:
(a) compression fracture.
(b) L-1 root irritation.
(c) L-5 root irritation.
(d) ruptured disc. - Correct Answer (c) L-5 root irritation.
A 38-year-old patient who is Vietnamese tells the family nurse practitioner that his or her parent died in his or her 40s
from liver cancer. The nurse practitioner assesses that the patient is at risk for:
(a) hepatitis B.
(b) malaria.
(c) tularemia.
(d) tyrosinemia. - Correct Answer (a) hepatitis B.
A 40-year-old patient has had a generalized, nonpruritic skin eruption with intermittent exacerbations over the past 10
years. Currently, a well-circumscribed erythematous plaque appears over the patient's left gluteal fold area. The
lesion is covered with scales and has some fissuring. The family nurse practitioner makes a diagnosis of:
(a) atopic dermatitis.
, (b) ichthyosis.
(c) psoriasis.
(d) tinea corporis. - Correct Answer (c) psoriasis.
A 42-year-old patient with epistaxis, dilated pupils, tachycardia, and mild euphoria shows symptoms associated with
the use of:
(a) benzodiazepine (Alprazolam).
(b) cocaine.
(c) morphine (MS Contin).
(d) oxycodone (OxyContin). - Correct Answer (b) cocaine.
A 45-year-old patient who is an opera singer reports progressive hoarseness for the last four weeks. The hoarseness
began after a three-hour opera performance. The patient does not smoke and reports no weight loss, upper
respiratory infection, dysphagia, or shortness of breath. The family nurse practitioner manages this patient by:
(a) ordering a computed tomography scan of the head.
(b) ordering an immediate lateral neck x-ray.
(c) prescribing systemic antibiotics and cool mist inhalations.
(d) requesting a referral for evaluation of the larynx. - Correct Answer (d) requesting a referral for evaluation of the
larynx.
A 45-year-old patient with diabetes comes to the clinic for an annual appointment. The patient declines a parenteral
influenza vaccination because a friend "came down with the flu after receiving the vaccination." The adult nurse
practitioner explains that the vaccination is:
(a) a polysaccharide, so it may cause a mild case of influenza.
(b) activated, so it may cause a mild case of influenza.
(c) inactivated, and this is unable to cause influenza.
(d) live attenuated, so it may cause a mild case of influenza. - Correct Answer (c) inactivated, and this is unable to
cause influenza.
A 55-year-old male patient who is Chinese has a follow-up appointment after cardiac bypass surgery. The patient
brings his father with him into the examination room. The family nurse practitioner provides culturally sensitive care
by:
(a) asking the patient's father if he has any questions regarding his son's care.
(b) asking the patient's father to leave the room due to confidentiality issues.
(c) performing the examination without commenting to the patient's father.
(d) performing the examination, then telling the patient's father the examination findings. - Correct Answer (a) asking
the patient's father if he has any questions regarding his son's care.
A 55-year-old man who has no history of diabetes mellitus, heart disease, hypertension, or thrombotic events is
diagnosed with paroxysmal atrial fibrillation. Based on national stroke prevention guidelines, the recommended
antithrombotic management for this patient is:
(a) aspirin (Bayer).
(b) aspirin with dipyridamole (Aggrenox).
(c) clopidogrel (Plavix).
(d) warfarin (Coumadin). - Correct Answer (a) aspirin (Bayer).
A 14-year-old, male patient has some general concerns about eczema, as his twin brother was recently diagnosed
with this condition. The patient reports urticaria and a rash on his posterior knees bilaterally. The three factors that put
the patient at risk for eczema are a family history of eczema, a personal history of allergic rhinitis, and a history of:
(a) asthma
(b) bee allergy
(c) otitis media
(d) psoriasis - Correct Answer (a) asthma
A 15-year-old patient with type 1 diabetes mellitus reports elevated blood glucose levels in the morning. An adult-
gerontology acute care nurse practitioner determines that the patient's hyperglycemia is due to the dawn
phenomenon and:
(a) increases the insulin dosage at bed time.
(b) reduces the insulin dosage at bed time.
(c) tests the blood glucose level at 3:00 AM every morning.
(d) tests the blood glucose level in the evening. - Correct Answer (a) increases the insulin dosage at bed time.
A 16-year-old patient has been diagnosed with mononucleosis and has a positive throat culture for group Alpha-
hemolytic streptococcal infection. The medication of choice for this patient is:
(a) amoxicillin (Amoxil).
(b) doxycycline (Vibramycin).
(c) erythromycin (E-Mycin).
(d) trimethoprim-sulfamethoxazole (Bactrim). - Correct Answer (c) erythromycin (E-Mycin).
A 19-year-old male patient arrives at the emergency department exhibiting symptoms of lower abdominal pain that
radiates to the groin, and that the patient rates as an 8 on a scale of 1 to 10. That patient states that the pain came on
suddenly, while he was playing football with friends. The patient's physical examination reveals positive bowel sounds
in all quadrants; a soft, non-tender abdomen; no rebounding and no guarding; and no palpable mass in the abdomen
or groin. Examination of the patient's genitalia reveals a unilateral cremasteric reflex. What is the adult-gerontology
acute care nurse practitioner's leading differential diagnosis, based on the patient's presentation?
(a) Appendicitis
(b) Epididymitis
(c) Inguinal hernia
(d) Testicular torsion - Correct Answer (d) Testicular torsion
A 21-year-old patient is admitted to the intensive care unit with a severe closed head injury. The patient's family is
becoming louder and more insistent about seeing the patient. To establish a therapeutic relationship with the family,
an acute care nurse practitioner's initial action is to:
(a) acknowledge the family's anxiety.
(b) arrange for a meeting with a social worker.
(c) escort the family to a conference room.
,(d) gently direct the family to maintain composure. - Correct Answer (a) acknowledge the family's anxiety.
A 24-year-old male patient with a closed head injury has been intubated for 12 days. The patient's parents have
repeatedly refused consent for a tracheostomy and long-term care placement. On multiple occasions, the surgeon
has discussed the risks and benefits of the surgery with them. Addressing the parents, the acute care nurse
practitioner states:
(a) "I understand you have reservations about the placement of a tracheostomy."
(b) "Please know that not many patients die while undergoing a tracheostomy."
(c) "Without a tracheostomy, we can't transfer your son to another facility."
(d) "You know, your son will die if a tracheostomy is not placed." - Correct Answer (a) "I understand you have
reservations about the placement of a tracheostomy."
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. - Correct Answer (d) Surface antigen.
A 32-year-old patient who underwent an open splenectomy for a ruptured spleen, is preparing for discharge. An
adult-gerontology acute care nurse practitioner reviews the potential complications with the patient. The nurse
practitioner emphasizes which instruction to the patient?
(a) Continue antibiotics for 14 days
(b) Follow up with primary care provider for vaccinations
(c) No international travel for five years
(d) No weight lifting restrictions - Correct Answer (b) Follow up with primary care provider for vaccinations
A 34-year-old truck driver reports a sharp pain in the lower back that worsens with ambulation. The symptoms began
after a strenuous three-day driving trip. During an examination, the patient has difficulty walking on the heels and
shows weakness in the extensors of the big toes. The initial differential diagnosis is:
(a) compression fracture.
(b) L-1 root irritation.
(c) L-5 root irritation.
(d) ruptured disc. - Correct Answer (c) L-5 root irritation.
A 38-year-old patient who is Vietnamese tells the family nurse practitioner that his or her parent died in his or her 40s
from liver cancer. The nurse practitioner assesses that the patient is at risk for:
(a) hepatitis B.
(b) malaria.
(c) tularemia.
(d) tyrosinemia. - Correct Answer (a) hepatitis B.
A 40-year-old patient has had a generalized, nonpruritic skin eruption with intermittent exacerbations over the past 10
years. Currently, a well-circumscribed erythematous plaque appears over the patient's left gluteal fold area. The
lesion is covered with scales and has some fissuring. The family nurse practitioner makes a diagnosis of:
(a) atopic dermatitis.
, (b) ichthyosis.
(c) psoriasis.
(d) tinea corporis. - Correct Answer (c) psoriasis.
A 42-year-old patient with epistaxis, dilated pupils, tachycardia, and mild euphoria shows symptoms associated with
the use of:
(a) benzodiazepine (Alprazolam).
(b) cocaine.
(c) morphine (MS Contin).
(d) oxycodone (OxyContin). - Correct Answer (b) cocaine.
A 45-year-old patient who is an opera singer reports progressive hoarseness for the last four weeks. The hoarseness
began after a three-hour opera performance. The patient does not smoke and reports no weight loss, upper
respiratory infection, dysphagia, or shortness of breath. The family nurse practitioner manages this patient by:
(a) ordering a computed tomography scan of the head.
(b) ordering an immediate lateral neck x-ray.
(c) prescribing systemic antibiotics and cool mist inhalations.
(d) requesting a referral for evaluation of the larynx. - Correct Answer (d) requesting a referral for evaluation of the
larynx.
A 45-year-old patient with diabetes comes to the clinic for an annual appointment. The patient declines a parenteral
influenza vaccination because a friend "came down with the flu after receiving the vaccination." The adult nurse
practitioner explains that the vaccination is:
(a) a polysaccharide, so it may cause a mild case of influenza.
(b) activated, so it may cause a mild case of influenza.
(c) inactivated, and this is unable to cause influenza.
(d) live attenuated, so it may cause a mild case of influenza. - Correct Answer (c) inactivated, and this is unable to
cause influenza.
A 55-year-old male patient who is Chinese has a follow-up appointment after cardiac bypass surgery. The patient
brings his father with him into the examination room. The family nurse practitioner provides culturally sensitive care
by:
(a) asking the patient's father if he has any questions regarding his son's care.
(b) asking the patient's father to leave the room due to confidentiality issues.
(c) performing the examination without commenting to the patient's father.
(d) performing the examination, then telling the patient's father the examination findings. - Correct Answer (a) asking
the patient's father if he has any questions regarding his son's care.
A 55-year-old man who has no history of diabetes mellitus, heart disease, hypertension, or thrombotic events is
diagnosed with paroxysmal atrial fibrillation. Based on national stroke prevention guidelines, the recommended
antithrombotic management for this patient is:
(a) aspirin (Bayer).
(b) aspirin with dipyridamole (Aggrenox).
(c) clopidogrel (Plavix).
(d) warfarin (Coumadin). - Correct Answer (a) aspirin (Bayer).
