ANCC EXAM QUESTIONS
A 50-year-old woman presents to the clinic for follow-up on her type 2 diabetes mellitus. She is
currently taking metformin (Glumetza) at her maximum tolerated dose, and her HbA1C at the
current appointment is 8.6%. The patient is not open to insulin and wants to try alternative
medications to reduce her HbA1C. Which of the following medications will directly stimulate the
release of insulin from pancreatic beta cells, thereby lowering blood glucose concentrations?
A.
Acarbose (Precose)
Incorrect
B.
Dulaglutide (Trulicity)
Incorrect
C.
Empagliflozin (Jardiance)
Incorrect
D.
Glipizide (Glucotrol) - ANS -Glipizide (Glucotrol)
An 18-year-old patient presents with unilateral ear pain for 2 days. On an otoscopic exam, the
tympanic membrane is bulging and appears inflamed. The posterior landmarks are obscured, and
the light reflex is distorted. Which of the following is the most likely diagnosis?
A.
Mastoiditis
Incorrect
B.
Otitis externa
Incorrect
C.
,Otitis media
Correct
D.
Presbycusis - ANS -Otitis media
A 7-year-old boy with a past medical history of atopic dermatitis presents to the clinic with his father
for concern about an allergic reaction. The boy states that 2 hours ago, after eating lunch, he
developed an itchy throat and eye swelling. He reports no wheezing or shortness of breath. The
physical exam does not show urticaria, and his airway is patent. Which of the following would be
responsible for oral allergy syndrome?
A.
Cow milk
Incorrect
B.
Eggs
Incorrect
C.
Peaches
Correct
D.
Salmon - ANS -Peaches
An 8-year-old boy presents to the office with an erythematous, nonpruritic, maculopapular rash in a
lacy pattern on his trunk and arms. His cheeks are also noticeably red. His mother reports that he
had a fever 1 week ago that resolved within 2 days without any other symptoms until now. He is
afebrile at the current visit. Which of the following is the most likely diagnosis?
A.
Erythema infectiosum
Correct
B.
,Hand, foot, and mouth disease
Incorrect
C.
Roseola
Incorrect
D.
Rubella - ANS -Erythema infectiosum
An 85-year-old man with recently diagnosed hypertension presents to the clinic for a BP check. Two
weeks ago, his BP was 168/74 mm Hg, and he started taking lisinopril (Zestril) 10 mg daily. He
reports no missed doses. His BP at the current visit is 128/78 mm Hg. What is the best next step in
his BP management?
A.
Add hydrochlorothiazide and reassess in 1 month
Incorrect
B.
Continue his lisinopril (Zestril) at the current dose
Correct
C.
Increase his lisinopril (Zestril) dose to 20 mg
Incorrect
D.
Stop lisinopril (Zestril) and start hydrochlorothiazide - ANS -Continue his lisinopril (Zestril) at the
current dose
A 66-year-old man presents to the clinic with a tremor for 6 months. He reports that it is mainly on
the left side of his body and is significantly worse when he is at rest. He states that it has also been
more difficult recently to use utensils and tools and that it takes him a long time to get out of chairs
and bed. The physical examination reveals a resting tremor, mild hyperreflexia on the left, and lead-
pipe rigidity in his joints. Which of the following is the best next step in confirming the suspected
diagnosis?
, A.
A levodopa or apomorphine challenge test
Incorrect
B.
Brain parenchyma sonography
Incorrect
C.
MRI
Incorrect
D.
Referral to a neurologist - ANS -Referral to a neurologist
A 45-year-old man with a BMI of 32 kg/m2 is following up at the clinic for weight loss. He explains to
the nurse practitioner that, for the past month, he has been trying to follow the recommended diet
and a 30-minute daily exercise routine but has only lost 2 pounds. Which of the following is the most
appropriate next step in the management of this patient's condition?
A.
Increase moderate exercise activity to 60 minutes/day
Incorrect
B.
Prescribe phentermine (Lomaira)
Incorrect
C.
Recommend stress management
Correct
D.
Refer patient for bariatric surgery - ANS -Recommend stress management
A 50-year-old woman presents to the clinic for follow-up on her type 2 diabetes mellitus. She is
currently taking metformin (Glumetza) at her maximum tolerated dose, and her HbA1C at the
current appointment is 8.6%. The patient is not open to insulin and wants to try alternative
medications to reduce her HbA1C. Which of the following medications will directly stimulate the
release of insulin from pancreatic beta cells, thereby lowering blood glucose concentrations?
A.
Acarbose (Precose)
Incorrect
B.
Dulaglutide (Trulicity)
Incorrect
C.
Empagliflozin (Jardiance)
Incorrect
D.
Glipizide (Glucotrol) - ANS -Glipizide (Glucotrol)
An 18-year-old patient presents with unilateral ear pain for 2 days. On an otoscopic exam, the
tympanic membrane is bulging and appears inflamed. The posterior landmarks are obscured, and
the light reflex is distorted. Which of the following is the most likely diagnosis?
A.
Mastoiditis
Incorrect
B.
Otitis externa
Incorrect
C.
,Otitis media
Correct
D.
Presbycusis - ANS -Otitis media
A 7-year-old boy with a past medical history of atopic dermatitis presents to the clinic with his father
for concern about an allergic reaction. The boy states that 2 hours ago, after eating lunch, he
developed an itchy throat and eye swelling. He reports no wheezing or shortness of breath. The
physical exam does not show urticaria, and his airway is patent. Which of the following would be
responsible for oral allergy syndrome?
A.
Cow milk
Incorrect
B.
Eggs
Incorrect
C.
Peaches
Correct
D.
Salmon - ANS -Peaches
An 8-year-old boy presents to the office with an erythematous, nonpruritic, maculopapular rash in a
lacy pattern on his trunk and arms. His cheeks are also noticeably red. His mother reports that he
had a fever 1 week ago that resolved within 2 days without any other symptoms until now. He is
afebrile at the current visit. Which of the following is the most likely diagnosis?
A.
Erythema infectiosum
Correct
B.
,Hand, foot, and mouth disease
Incorrect
C.
Roseola
Incorrect
D.
Rubella - ANS -Erythema infectiosum
An 85-year-old man with recently diagnosed hypertension presents to the clinic for a BP check. Two
weeks ago, his BP was 168/74 mm Hg, and he started taking lisinopril (Zestril) 10 mg daily. He
reports no missed doses. His BP at the current visit is 128/78 mm Hg. What is the best next step in
his BP management?
A.
Add hydrochlorothiazide and reassess in 1 month
Incorrect
B.
Continue his lisinopril (Zestril) at the current dose
Correct
C.
Increase his lisinopril (Zestril) dose to 20 mg
Incorrect
D.
Stop lisinopril (Zestril) and start hydrochlorothiazide - ANS -Continue his lisinopril (Zestril) at the
current dose
A 66-year-old man presents to the clinic with a tremor for 6 months. He reports that it is mainly on
the left side of his body and is significantly worse when he is at rest. He states that it has also been
more difficult recently to use utensils and tools and that it takes him a long time to get out of chairs
and bed. The physical examination reveals a resting tremor, mild hyperreflexia on the left, and lead-
pipe rigidity in his joints. Which of the following is the best next step in confirming the suspected
diagnosis?
, A.
A levodopa or apomorphine challenge test
Incorrect
B.
Brain parenchyma sonography
Incorrect
C.
MRI
Incorrect
D.
Referral to a neurologist - ANS -Referral to a neurologist
A 45-year-old man with a BMI of 32 kg/m2 is following up at the clinic for weight loss. He explains to
the nurse practitioner that, for the past month, he has been trying to follow the recommended diet
and a 30-minute daily exercise routine but has only lost 2 pounds. Which of the following is the most
appropriate next step in the management of this patient's condition?
A.
Increase moderate exercise activity to 60 minutes/day
Incorrect
B.
Prescribe phentermine (Lomaira)
Incorrect
C.
Recommend stress management
Correct
D.
Refer patient for bariatric surgery - ANS -Recommend stress management
