AANP FNP Certification case Study Guide Exam Questions
with Verified answers 2025/2026
Which of the following is a potential serious complication of Mrs. Jensen's presumptive
diagnosis?
Based on the scenario below:
Mrs. Jensen is an 82-year-old woman with generalized osteoarthritis and systolic
hypertension who presents with a 3-day history of right-sided headache with
accompanying right-sided jaw pain on chewing. OTC analgesics have provided little
relief. She states she is eating little due to the pain on chewing but is taking liquids
without difficulty. Mrs. Jensen reports "I can hardly wash my hair, my scalp is so sore."
Physical examination reveals: BP=168/88 mm Hg bilateral, P=88 regular, RR=18, alert,
appears uncomfortable with poorly-groomed hair on the right only PERLA, cranial nerve
function II‒XII intact, remaining neurological exam WNL, carotid upstroke within normal
limits without bruit. There is a tender, palpable, pulseless structure in the right temple
area.
Hemiparesis
Arthritis
B - correct answer Blindness
When counseling a patient about lifestyle modifications to prevent migraines, the NP
recommends:
Using tinted glasses to minimize glare and bright lights
Substituting artificial sweeteners for cane sugar
Avoiding regular exercise for at least one week after each migraine episode
,Moving to a high-altitude environment - correct answer Using tinted glasses to
minimize glare and bright lights
Which of the following agents can be considered for migraine controller therapy in a 54-
year-old with a history of hypertension?
Sumatriptan
Topiramate
NSAIDs
Ergotamine - correct answer
Topiramate
Reasonable goals for using headache prophylactic therapy include all of the following
except:
Reduce the frequency of headaches
Reduce the severity of headaches
Eliminate the incidence of headaches
Allow headache medications to work more effectively - correct answer Eliminate the
incidence of headaches
Which of the following is unlikely to be reported by Mr. Kane, a 45-year-old man with a
BMI=41 kg/m2 who presents with typical GERD symptoms?
,Unintended weight loss
Hoarseness.
A recurrent cough
Chronic pharyngitis - correct answer
Unintended weight loss
Anticipated clinical findings in acute appendicitis for Jordan, an otherwise well 24-year-
old man with a BMI=32 kg/m2 include all of the following except:
Leukocytosis with neutrophilia and bandemia
Positive obturator and psoas signs
A 2-hour history of sudden onset of vomiting and generalized abdominal pain
accompanied by fever
A 12-hour history of epigastric discomfort and anorexia that gradually shifts to nausea
and right lower quadrant abdominal pain - correct answer A 2-hour history of sudden
onset of vomiting and generalized abdominal pain accompanied by fever
Mr. Lam, a 78-year-old man with longstanding GERD, presents with a 1-month history
of "feeling like the food gets stuck way down in my throat." This sensation occurs with
meats and other solid food types and less likely with softer or liquid foods. He denies
nausea, vomiting, constipation, diarrhea, aspiration, or melena. His physical
examination is unremarkable. A hemogram today reveals a microcytic hypochromic
anemia with an elevated RDW. The most likely etiology of this anemia is:
, Anemia of chronic disease
Vitamin B12 deficiency
Iron deficiency
Acute blood loss - correct answer
Iron deficiency
All of the following diagnostic studies are available as part of Mr. Lam's evaluation. Rank
from 1 (most helpful) to 3 (least helpful) as these tests pertain to the evaluation of Mr.
Lam's symptoms.
Based on the scenario below:
Mr. Lam, a 78-year-old man with longstanding GERD, presents with a 1-month history
of "feeling like the food gets stuck way down in my throat." This sensation occurs with
meats and other solid food types and less likely with softer or liquid foods. He denies
nausea, vomiting, constipation, diarrhea, aspiration, or melena. His physical
examination is unremarkable. A hemogram today reveals a microcytic hypochromic
anemia with an elevated RDW.
A. Barium swallow __
B. Upper endoscopy __
C. Abdominal ultrasound __
A-2 B-1 C-3
A-1 B-2 C-3
with Verified answers 2025/2026
Which of the following is a potential serious complication of Mrs. Jensen's presumptive
diagnosis?
Based on the scenario below:
Mrs. Jensen is an 82-year-old woman with generalized osteoarthritis and systolic
hypertension who presents with a 3-day history of right-sided headache with
accompanying right-sided jaw pain on chewing. OTC analgesics have provided little
relief. She states she is eating little due to the pain on chewing but is taking liquids
without difficulty. Mrs. Jensen reports "I can hardly wash my hair, my scalp is so sore."
Physical examination reveals: BP=168/88 mm Hg bilateral, P=88 regular, RR=18, alert,
appears uncomfortable with poorly-groomed hair on the right only PERLA, cranial nerve
function II‒XII intact, remaining neurological exam WNL, carotid upstroke within normal
limits without bruit. There is a tender, palpable, pulseless structure in the right temple
area.
Hemiparesis
Arthritis
B - correct answer Blindness
When counseling a patient about lifestyle modifications to prevent migraines, the NP
recommends:
Using tinted glasses to minimize glare and bright lights
Substituting artificial sweeteners for cane sugar
Avoiding regular exercise for at least one week after each migraine episode
,Moving to a high-altitude environment - correct answer Using tinted glasses to
minimize glare and bright lights
Which of the following agents can be considered for migraine controller therapy in a 54-
year-old with a history of hypertension?
Sumatriptan
Topiramate
NSAIDs
Ergotamine - correct answer
Topiramate
Reasonable goals for using headache prophylactic therapy include all of the following
except:
Reduce the frequency of headaches
Reduce the severity of headaches
Eliminate the incidence of headaches
Allow headache medications to work more effectively - correct answer Eliminate the
incidence of headaches
Which of the following is unlikely to be reported by Mr. Kane, a 45-year-old man with a
BMI=41 kg/m2 who presents with typical GERD symptoms?
,Unintended weight loss
Hoarseness.
A recurrent cough
Chronic pharyngitis - correct answer
Unintended weight loss
Anticipated clinical findings in acute appendicitis for Jordan, an otherwise well 24-year-
old man with a BMI=32 kg/m2 include all of the following except:
Leukocytosis with neutrophilia and bandemia
Positive obturator and psoas signs
A 2-hour history of sudden onset of vomiting and generalized abdominal pain
accompanied by fever
A 12-hour history of epigastric discomfort and anorexia that gradually shifts to nausea
and right lower quadrant abdominal pain - correct answer A 2-hour history of sudden
onset of vomiting and generalized abdominal pain accompanied by fever
Mr. Lam, a 78-year-old man with longstanding GERD, presents with a 1-month history
of "feeling like the food gets stuck way down in my throat." This sensation occurs with
meats and other solid food types and less likely with softer or liquid foods. He denies
nausea, vomiting, constipation, diarrhea, aspiration, or melena. His physical
examination is unremarkable. A hemogram today reveals a microcytic hypochromic
anemia with an elevated RDW. The most likely etiology of this anemia is:
, Anemia of chronic disease
Vitamin B12 deficiency
Iron deficiency
Acute blood loss - correct answer
Iron deficiency
All of the following diagnostic studies are available as part of Mr. Lam's evaluation. Rank
from 1 (most helpful) to 3 (least helpful) as these tests pertain to the evaluation of Mr.
Lam's symptoms.
Based on the scenario below:
Mr. Lam, a 78-year-old man with longstanding GERD, presents with a 1-month history
of "feeling like the food gets stuck way down in my throat." This sensation occurs with
meats and other solid food types and less likely with softer or liquid foods. He denies
nausea, vomiting, constipation, diarrhea, aspiration, or melena. His physical
examination is unremarkable. A hemogram today reveals a microcytic hypochromic
anemia with an elevated RDW.
A. Barium swallow __
B. Upper endoscopy __
C. Abdominal ultrasound __
A-2 B-1 C-3
A-1 B-2 C-3
