ANCC AGPCNP
Practice
Questions with
Accurate
Answers
A 19-year-old woman has recently been diagnosed with acute hepatitis B. She is sexually active and is
monogamous. She reports that her partner uses condoms inconsistently. What would you recommend
for her male sexual partner who was also tested for hepatitis with the following results: HBsAg (−), anti-
HBc (−), anti-HBs (−), anti-HCV (−), anti-HAV (+)?
A.Hepatitis B vaccination
B.Hepatitis B immunoglobulin
C.Hepatitis B vaccination and hepatitis B immunoglobulin
D.No vaccination is needed at this time correct answer C.Hepatitis B vaccination and hepatitis B
immunoglobulin
HBsAg is a marker of infectivity. If positive, it indicates either an acute or chronic hepatitis B infection, so
the partner does not have acute or chronic hepatitis B infection. Anti-HBs is a marker of immunity and
because this is negative, it indicates that the partner is not immune to hepatitis B. Antibody to hepatitis
B core antigen (anti-HBc) is a marker of acute, chronic, or resolved hepatitis B virus (HBV) infection; it
may be used in pre-vaccination testing to determine previous exposure to HBV. The hepatitis B panel
results for the individual in this question (negative HBsAg, anti-HBc, and anti-HBs) indicate the partner is
susceptible (not immune), has not been infected, and is still at risk of future infection—and thus needs
vaccine. Hepatitis B immunoglobulin contains antibodies that provide "instant" immunity against
hepatitis B, but its action lasts for several days only. It is not a vaccine. It is given to infants and others
who are at high risk of becoming infected and are not immune. The hepatitis B vaccine stimulates the
,body to make its own antibodies, which are permanent. A total of three doses are needed to gain full
immunity against hepatitis B. Interpretation of the negative anti-HCV screening test indicates that the
partner is not infected with Hepatitis C. The positive anti-HAV indicates that the individual is immune
(either from previous disease or from vaccination) to Hepatitis A.
A 20-year-old woman reports that for several years, she has had random episodes of palpitations and
shortness of breath that resolve spontaneously. She denies chest pain, arm pain, and syncope. Her past
medical and family histories are negative for coronary artery disease, stroke, or lung disease. During the
cardiac exam, the nurse practitioner notices a grade 3/6 murmur that is accompanied by a midsystolic
click, which is best heard at the apical area. The apical pulse is 78 beats/min, blood pressure is 120/60
mmHg, and temperature is 98.6°F. The cardiac exam is highly suggestive of which of the following
conditions?
a. Mitral valve prolapse (MVP)
b. Aortic stenosis
c. Atrial septal defect
d. Pulmonary regurgitation correct answer a. Mitral valve prolapse
A systolic murmur that is accompanied by a midsystolic click located at the apical area is a classic finding
of MVP. Most cases of MVP are asymptomatic. To detect MVP, order an echocardiogram with Doppler
imaging.
A 22-year-old presents for her annual gynecological exam and testing. The Pap smear result shows ASC-
US. Which of the following is the best management for this patient?
a. Check for high-risk HPV
b. Repeat Pap in 12 months
c. Refer patient for colposcopy
d. Refer patient for endometrial biopsy correct answer b. Repeat pap in 12 months
The appropriate follow-up for a 22-year-old with a Pap smear result of ASC-US is to perform a repeat
Pap smear in 12 months. HPV testing is not recommended for this age group with ASC-US. A colposcopy
is not recommended for ASC-US, as most cases clear spontaneously in young women. An endometrial
biopsy is not appropriate follow-up for ASC-US, since it does not involve the endometrium.
,A 22-year-old woman is going on a 5-day cruise for her honeymoon. She reports a history of severe
motion sickness. Which of the following medicines can be prescribed for motion sickness?
a. Dimenhydrinate (Dramamine)
b. Metoclopramide (Reglan)
c. Ondansetron (Zofran)
d. Scopolamine patch (Transderm Scop) correct answer d. Scopolamine patch (Transderm Scop)
Scopolamine patch (Transderm Scop) is a prescription medicine that is used for motion/sea sickness. It is
a small, circular patch that is placed behind the ear and is effective for 3 days. Advise the patient to
apply it 4 hours before the trip to be effective. Because the question is asking about a "prescribed"
medication, an over-the-counter (OTC) medicine, such as Dramamine, is an incorrect response. Zofran is
indicated for cancer-related nausea and vomiting (chemotherapy, radiation, surgery).
A 35-year-old woman smokes approximately 10 cigarettes per day. She started smoking at the age of 18
years. She has a new male sexual partner and is interested in contraception. She was recently treated
for gonorrhea and chlamydia. She is using condoms inconsistently. The urine pregnancy test is negative.
She denies a history of hypertension, blood clots, liver disease, heart disease, and diabetes. Her last
menstrual period was 5 days ago. Which of the following contraceptive methods is recommended?
a. Oral contraceptive pills
b. Copper IUD
c. Etonogestrel implant (Nexplanon)
d. Vaginal ring (NuvaRing) correct answer c. Etonogestrel implant (Nexplanon)
An etonogestrel implant (Nexplanon) is the best option for this patient. It is a progesterone-only
method. The 35-year-old patient is a smoker, so she cannot take oral contraceptives, which contain
estrogen/progesterone. An IUD (copper or progestin) is contraindicated until the patient is retested (4-6
weeks after treatment) to ensure that her gonorrhea and chlamydia infections are gone. The vaginal ring
(NuvaRing) contains estrogen and progesterone; it is contraindicated for this patient.
A 45-year-old gardener is seen as a walk-in patient in a private clinic. He reports stepping on a nail that
morning. He received a Td vaccine 9 years ago. Which of the following vaccines is recommended?
, a. Diphtheria, tetanus, acellular pertussis (DTaP)
b. Diphtheria and tetanus (DT)
c. Tetanus diphtheria (Td)
d. Tetanus, diphtheria, acellular pertussis (Tdap) correct answer d. Tetanus, diphtheria, acellular
pertussis (Tdap)
The Centers for Disease Control and Prevention (CDC) recommends that one of the tetanus boosters be
replaced with the Tdap (once in a lifetime). Thereafter, the Td form of the vaccine is indicated every 10
years. The DTaP and DT forms of the tetanus vaccine are not given after the age of 7 years. Puncture
wounds are at higher risk for tetanus because Clostridium tetani bacteria are anaerobes (deep puncture
wounds are not exposed to air compared with superficial wounds).
A 55-year-old male presents with a swollen, painful right testicle and burning on urination. Examination
reveals edematous scrotum with tenderness and a positive Prehn's sign. The patient states he is
heterosexual and has been in a monogamous relationship for the past 5 years. He denies practicing anal
intercourse. The nucleic acid amplification test (NAAT) is negative. Which medication will the nurse
practitioner prescribe?
a. Ceftriaxone 250 mg IM
b. Levofloxacin 500 mg PO × 10 days
c. Doxycycline 100 mg PO BID × 10 days
d. Ceftriaxone 250 mg IM and ofloxacin 300 mg PO BID × 10 days correct answer b. Levofloxacin 500 mg
PO × 10 days.
The results of the NAAT indicate the patient is negative for chlamydia and gonorrhea. In an older male,
acute epididymitis, caused by enteric organisms (generally gram-negative Escherichia coli ), is the
probable diagnosis. Levofloxacin 500 mg orally once a day for 10 days is the treatment of choice.
Epididymitis is diagnosis for most commonly gram-negative E. coli. Ceftriaxone 250 mg IM in addition to
Doxycycline 100 mg orally twice a day for 10 days is recommended for patients with epididymitis caused
by chlamydia and gonorrhea. Ceftriaxone 250 mg IM in addition to ofloxacin 300 mg orally twice a day
for 10 days is indicated for patients with acute epididymitis most likely caused by sexually transmitted
chlamydia and gonorrhea, as well of the probability of enteric organisms obtained by men who practice
anal sex.
Practice
Questions with
Accurate
Answers
A 19-year-old woman has recently been diagnosed with acute hepatitis B. She is sexually active and is
monogamous. She reports that her partner uses condoms inconsistently. What would you recommend
for her male sexual partner who was also tested for hepatitis with the following results: HBsAg (−), anti-
HBc (−), anti-HBs (−), anti-HCV (−), anti-HAV (+)?
A.Hepatitis B vaccination
B.Hepatitis B immunoglobulin
C.Hepatitis B vaccination and hepatitis B immunoglobulin
D.No vaccination is needed at this time correct answer C.Hepatitis B vaccination and hepatitis B
immunoglobulin
HBsAg is a marker of infectivity. If positive, it indicates either an acute or chronic hepatitis B infection, so
the partner does not have acute or chronic hepatitis B infection. Anti-HBs is a marker of immunity and
because this is negative, it indicates that the partner is not immune to hepatitis B. Antibody to hepatitis
B core antigen (anti-HBc) is a marker of acute, chronic, or resolved hepatitis B virus (HBV) infection; it
may be used in pre-vaccination testing to determine previous exposure to HBV. The hepatitis B panel
results for the individual in this question (negative HBsAg, anti-HBc, and anti-HBs) indicate the partner is
susceptible (not immune), has not been infected, and is still at risk of future infection—and thus needs
vaccine. Hepatitis B immunoglobulin contains antibodies that provide "instant" immunity against
hepatitis B, but its action lasts for several days only. It is not a vaccine. It is given to infants and others
who are at high risk of becoming infected and are not immune. The hepatitis B vaccine stimulates the
,body to make its own antibodies, which are permanent. A total of three doses are needed to gain full
immunity against hepatitis B. Interpretation of the negative anti-HCV screening test indicates that the
partner is not infected with Hepatitis C. The positive anti-HAV indicates that the individual is immune
(either from previous disease or from vaccination) to Hepatitis A.
A 20-year-old woman reports that for several years, she has had random episodes of palpitations and
shortness of breath that resolve spontaneously. She denies chest pain, arm pain, and syncope. Her past
medical and family histories are negative for coronary artery disease, stroke, or lung disease. During the
cardiac exam, the nurse practitioner notices a grade 3/6 murmur that is accompanied by a midsystolic
click, which is best heard at the apical area. The apical pulse is 78 beats/min, blood pressure is 120/60
mmHg, and temperature is 98.6°F. The cardiac exam is highly suggestive of which of the following
conditions?
a. Mitral valve prolapse (MVP)
b. Aortic stenosis
c. Atrial septal defect
d. Pulmonary regurgitation correct answer a. Mitral valve prolapse
A systolic murmur that is accompanied by a midsystolic click located at the apical area is a classic finding
of MVP. Most cases of MVP are asymptomatic. To detect MVP, order an echocardiogram with Doppler
imaging.
A 22-year-old presents for her annual gynecological exam and testing. The Pap smear result shows ASC-
US. Which of the following is the best management for this patient?
a. Check for high-risk HPV
b. Repeat Pap in 12 months
c. Refer patient for colposcopy
d. Refer patient for endometrial biopsy correct answer b. Repeat pap in 12 months
The appropriate follow-up for a 22-year-old with a Pap smear result of ASC-US is to perform a repeat
Pap smear in 12 months. HPV testing is not recommended for this age group with ASC-US. A colposcopy
is not recommended for ASC-US, as most cases clear spontaneously in young women. An endometrial
biopsy is not appropriate follow-up for ASC-US, since it does not involve the endometrium.
,A 22-year-old woman is going on a 5-day cruise for her honeymoon. She reports a history of severe
motion sickness. Which of the following medicines can be prescribed for motion sickness?
a. Dimenhydrinate (Dramamine)
b. Metoclopramide (Reglan)
c. Ondansetron (Zofran)
d. Scopolamine patch (Transderm Scop) correct answer d. Scopolamine patch (Transderm Scop)
Scopolamine patch (Transderm Scop) is a prescription medicine that is used for motion/sea sickness. It is
a small, circular patch that is placed behind the ear and is effective for 3 days. Advise the patient to
apply it 4 hours before the trip to be effective. Because the question is asking about a "prescribed"
medication, an over-the-counter (OTC) medicine, such as Dramamine, is an incorrect response. Zofran is
indicated for cancer-related nausea and vomiting (chemotherapy, radiation, surgery).
A 35-year-old woman smokes approximately 10 cigarettes per day. She started smoking at the age of 18
years. She has a new male sexual partner and is interested in contraception. She was recently treated
for gonorrhea and chlamydia. She is using condoms inconsistently. The urine pregnancy test is negative.
She denies a history of hypertension, blood clots, liver disease, heart disease, and diabetes. Her last
menstrual period was 5 days ago. Which of the following contraceptive methods is recommended?
a. Oral contraceptive pills
b. Copper IUD
c. Etonogestrel implant (Nexplanon)
d. Vaginal ring (NuvaRing) correct answer c. Etonogestrel implant (Nexplanon)
An etonogestrel implant (Nexplanon) is the best option for this patient. It is a progesterone-only
method. The 35-year-old patient is a smoker, so she cannot take oral contraceptives, which contain
estrogen/progesterone. An IUD (copper or progestin) is contraindicated until the patient is retested (4-6
weeks after treatment) to ensure that her gonorrhea and chlamydia infections are gone. The vaginal ring
(NuvaRing) contains estrogen and progesterone; it is contraindicated for this patient.
A 45-year-old gardener is seen as a walk-in patient in a private clinic. He reports stepping on a nail that
morning. He received a Td vaccine 9 years ago. Which of the following vaccines is recommended?
, a. Diphtheria, tetanus, acellular pertussis (DTaP)
b. Diphtheria and tetanus (DT)
c. Tetanus diphtheria (Td)
d. Tetanus, diphtheria, acellular pertussis (Tdap) correct answer d. Tetanus, diphtheria, acellular
pertussis (Tdap)
The Centers for Disease Control and Prevention (CDC) recommends that one of the tetanus boosters be
replaced with the Tdap (once in a lifetime). Thereafter, the Td form of the vaccine is indicated every 10
years. The DTaP and DT forms of the tetanus vaccine are not given after the age of 7 years. Puncture
wounds are at higher risk for tetanus because Clostridium tetani bacteria are anaerobes (deep puncture
wounds are not exposed to air compared with superficial wounds).
A 55-year-old male presents with a swollen, painful right testicle and burning on urination. Examination
reveals edematous scrotum with tenderness and a positive Prehn's sign. The patient states he is
heterosexual and has been in a monogamous relationship for the past 5 years. He denies practicing anal
intercourse. The nucleic acid amplification test (NAAT) is negative. Which medication will the nurse
practitioner prescribe?
a. Ceftriaxone 250 mg IM
b. Levofloxacin 500 mg PO × 10 days
c. Doxycycline 100 mg PO BID × 10 days
d. Ceftriaxone 250 mg IM and ofloxacin 300 mg PO BID × 10 days correct answer b. Levofloxacin 500 mg
PO × 10 days.
The results of the NAAT indicate the patient is negative for chlamydia and gonorrhea. In an older male,
acute epididymitis, caused by enteric organisms (generally gram-negative Escherichia coli ), is the
probable diagnosis. Levofloxacin 500 mg orally once a day for 10 days is the treatment of choice.
Epididymitis is diagnosis for most commonly gram-negative E. coli. Ceftriaxone 250 mg IM in addition to
Doxycycline 100 mg orally twice a day for 10 days is recommended for patients with epididymitis caused
by chlamydia and gonorrhea. Ceftriaxone 250 mg IM in addition to ofloxacin 300 mg orally twice a day
for 10 days is indicated for patients with acute epididymitis most likely caused by sexually transmitted
chlamydia and gonorrhea, as well of the probability of enteric organisms obtained by men who practice
anal sex.
