AANP Review Questions and Answers 2026 (Verified
Answers)
A 64 year old with HTN and DM presents with productive cough, fever, body aches. What diagnosis is
most likely?
a. Acute bronchitis
b. Chronic bronchitis
c. Pneumonia
- ANSWER- d. Pertussisc. Pneumonia
1st clue: 64 year old
2nd clue: multiple comorbidities
3rd clue: cough, fever what was the
stem of the question?
Indications for a chest xray with acute - ANSWER- coughabnormal vital signs (increased RR or
HR, temp >38c, 100.4F
rales, consolidation
> or equal 75 years of age with cough***
***Pneumonia in older patient: tachypnea, decreased O2 sat, OR change in mental status or behavior
A 75 year old patient wo smokes and has COPD presents with a worsening cough, weight loss, fatigue,
and an enlarged right supraclavicular node. Which finding is most indicative of a right lung tumor?
1. worsening cough
2. weight loss
3. fatigue
4. supraclavicular - ANSWER- node4. supraclavicular node most important stem clue because
this lymph node drains the chest and breast. It's a BIG deal!
If the stem gives a unilateral finding, look for a unilateral diagnosis
What symptoms most commonly accompany acute bronchitis?
1. Fever, runny nose
2. Cough, fever
3. Cough and URI symptoms
4. Cough, URI, and - ANSWER- headache3. Cough and URI symptoms
Remember that bronchitis is an inflammation of the bronchioles, bronchi, and trachea; usually follows
an upper respiratory infection
Starts above the shoulders and drops down into chest.
A 35 year old patient with acute bronchitis has no underlying lung disease. He asks, "How long before
my cough goes aways?" The NP responds:
1. <1 week
2. about 1 week
3. 1-3 weeks
4. >3 - ANSWER- weeks3. 1-3 weeks
, The patient with bronchitis will have evidence of upper AND lower airway symptoms.
COUGH, COUGH, COUGH, usually worse at night!
What is the management of - ANSWER- bronchitis?Treat symptoms!
Time is the only thing for bronchitis
ABX usually prescribed, but usually not necessary
Differential Diagnosis for Acute - ANSWER- BronchitisPND
Asthma
PNA
Pertussis
TB
Supraclavicular nodes: associated with high rates of malignancy. What organs are on the
- ANSWER- right vs left? RT: Lungs, mediastinum, esophagus
LT: Abdominal malignancy: stomach GB liver pancreas ovaries prostate
Pneumonia Vaccine
Who?
Who else?
When is it given - ANSWER- again?Who-Prevention: Pneumococcal polysaccharide vaccination
(PPSV)
given once in a lifetime to immunocompetent adults > or equal 65 years
Who else-Adults 19-64 with
--chronic CV, lung, liver disease
--smokers, DM, ETOH, or asplenic
--chronic care facilities
--immunocompromising conditions
When again-one time 5 years after for CRF, nephrotic syndrome, asplenia, sickle cell,
immunocompromising conditions
A 52 year old feale was recently diagnosed with RA. She is being treated with a DMARD.
Should she receive PPSV? If so, should she receive another one, and if so when?
1. Yes, in 5 years
2. No, another is not needed
3. Yes, at 65 years old
4. Yes, at age 60 - ANSWER- yearsYes, in 5 years
What are some presentation symptoms for pneumonia?
What is the classical - ANSWER- presentation?Cough (>90%)
Sputum production, purulent
Fever, malaise, fatigue
SOB
Chest pain >50%, especially with inspiration, or between shoulder blades (classical presentation)
Increased RR and HR
What are the common pathogens for - ANSWER- CAP?S. pneumoniae - rust colored sputum.
Most common cause of death from PNA - Bad for business!
or atypical organisms:
M. pneumoniae - mycoplasma pneu. aka "Walking PNA"
Chlamydophila pneumoniae
Answers)
A 64 year old with HTN and DM presents with productive cough, fever, body aches. What diagnosis is
most likely?
a. Acute bronchitis
b. Chronic bronchitis
c. Pneumonia
- ANSWER- d. Pertussisc. Pneumonia
1st clue: 64 year old
2nd clue: multiple comorbidities
3rd clue: cough, fever what was the
stem of the question?
Indications for a chest xray with acute - ANSWER- coughabnormal vital signs (increased RR or
HR, temp >38c, 100.4F
rales, consolidation
> or equal 75 years of age with cough***
***Pneumonia in older patient: tachypnea, decreased O2 sat, OR change in mental status or behavior
A 75 year old patient wo smokes and has COPD presents with a worsening cough, weight loss, fatigue,
and an enlarged right supraclavicular node. Which finding is most indicative of a right lung tumor?
1. worsening cough
2. weight loss
3. fatigue
4. supraclavicular - ANSWER- node4. supraclavicular node most important stem clue because
this lymph node drains the chest and breast. It's a BIG deal!
If the stem gives a unilateral finding, look for a unilateral diagnosis
What symptoms most commonly accompany acute bronchitis?
1. Fever, runny nose
2. Cough, fever
3. Cough and URI symptoms
4. Cough, URI, and - ANSWER- headache3. Cough and URI symptoms
Remember that bronchitis is an inflammation of the bronchioles, bronchi, and trachea; usually follows
an upper respiratory infection
Starts above the shoulders and drops down into chest.
A 35 year old patient with acute bronchitis has no underlying lung disease. He asks, "How long before
my cough goes aways?" The NP responds:
1. <1 week
2. about 1 week
3. 1-3 weeks
4. >3 - ANSWER- weeks3. 1-3 weeks
, The patient with bronchitis will have evidence of upper AND lower airway symptoms.
COUGH, COUGH, COUGH, usually worse at night!
What is the management of - ANSWER- bronchitis?Treat symptoms!
Time is the only thing for bronchitis
ABX usually prescribed, but usually not necessary
Differential Diagnosis for Acute - ANSWER- BronchitisPND
Asthma
PNA
Pertussis
TB
Supraclavicular nodes: associated with high rates of malignancy. What organs are on the
- ANSWER- right vs left? RT: Lungs, mediastinum, esophagus
LT: Abdominal malignancy: stomach GB liver pancreas ovaries prostate
Pneumonia Vaccine
Who?
Who else?
When is it given - ANSWER- again?Who-Prevention: Pneumococcal polysaccharide vaccination
(PPSV)
given once in a lifetime to immunocompetent adults > or equal 65 years
Who else-Adults 19-64 with
--chronic CV, lung, liver disease
--smokers, DM, ETOH, or asplenic
--chronic care facilities
--immunocompromising conditions
When again-one time 5 years after for CRF, nephrotic syndrome, asplenia, sickle cell,
immunocompromising conditions
A 52 year old feale was recently diagnosed with RA. She is being treated with a DMARD.
Should she receive PPSV? If so, should she receive another one, and if so when?
1. Yes, in 5 years
2. No, another is not needed
3. Yes, at 65 years old
4. Yes, at age 60 - ANSWER- yearsYes, in 5 years
What are some presentation symptoms for pneumonia?
What is the classical - ANSWER- presentation?Cough (>90%)
Sputum production, purulent
Fever, malaise, fatigue
SOB
Chest pain >50%, especially with inspiration, or between shoulder blades (classical presentation)
Increased RR and HR
What are the common pathogens for - ANSWER- CAP?S. pneumoniae - rust colored sputum.
Most common cause of death from PNA - Bad for business!
or atypical organisms:
M. pneumoniae - mycoplasma pneu. aka "Walking PNA"
Chlamydophila pneumoniae
