AANP AGPCNP PSI Test 1 & 2
An 88-year-old presents with right-side weakness after being unable to rise unassisted
following a fall to the bathroom floor. History includes aphasia and noncompliance with
hypertension medication regimen. What is the most likely diagnosis?
Left-sided or right-sided CVA? - Answer LEFT-SIDED CVA
Which of the following signs/symtpoms are often associated with headahces due to
intracranial tumor?
1) pain worse laying down, focal neurological signs
2) Hyperflexia, personality change
3) acute onset: hours to days
4) pupillary constriction; stupor - Answer 1) pain worse laying down, focal neurological
signs
Which of the following pharmacotherapeutics would be most important to administer to
a patient who has a corneal abrasion?
1) Timolol
2) Gentamicin ophthalmic
3) Cromolyn optha
4) Olopatadine - Answer 2) Gentamicin ophthalmic (Genoptic)
A 25-year-old presents with the chief complaint of decreased mobility and pain of the
right shoulder exacerbated by movement. The patient reports that he participated in
extensive house painting 24 hours prior to the onset of pain. He denies any trauma.
Passive ROM is intact. No redness or ecchymosis is present. What is the next step to
be taken in order to make a diagnosis?
1) Xray of shoulder
2) Palpate structures around the shoulder.
3) MRI of shoulder
4) EMG - Answer 2) palpate structures
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of
midcycle spotting. She has not missed any doses and uses no other medication. Which
of the following is appropriate?
1) Changing to Ortho-Novum 1/35
2) Discontinue use
3) Providing reassurance
4) Double dose-for two days - Answer 3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the
following is NOT a current recommendation guideline for preventive care in elderly
female patients?
,AANP AGPCNP PSI Test 1 & 2
1) Mammogram and clinical breast exams
2) Fecal Occult blood test and/or sig
3) Rubella serology or vaccination history
4) Pnuemo and influenza vaccines - Answer 3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R
10. The best action is to:
1) initiate passive warming
2) apply a rebreather
3) Perform fluid replacement
4) initiate active warming - Answer 1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How
would you educate this patient on recognizing the signs and symptoms of
hypoglycemia?
1) Edema
2) Tachycardia
3) palpitations
4) sweating - Answer 4) sweating
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of
NSAIDs, stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-
up plan of care would be to:
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
2) continue NSAID, apply an arch support and encourage wt loss and exercise
3) continue NSAID, xray and add a short-leg night splint
4) COntinue NSAID, xray and add a metatarsal bar - Answer 2) continue NSAID, apply
an arch support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
1) nicking of arteriols and viens, and small retinol hemorrages
2) drusen bodies and pale retina
3) pale macula and swollen disk margins
4) microaneurysms and optic disc cupping - Answer 1) nicking of arteriols and viens,
and small retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
3) atrial fibrillation
,AANP AGPCNP PSI Test 1 & 2
4) abnormal T3 suppression - Answer 3) atrial fibrillation
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since
the previous day. The eye was rinsed with over-the-counter eyewash, without relief. The
patient denies visual disturbances or drainage. In formulating a plan of care, the nurse
practitioner would FIRST:
1) send to ophthalmologists
2) florescreen staining
3) test visual field
4) prescribe eyedrops - Answer 3) test visual field
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical
examination, the nurse practitioner notes the presence of a gray band of opacity in the
cornea that encircles the iris. The band is 1.0-1.5 mm wide. This finding is most
consistent with a diagnosis of a/an:
1. corneal abrasion
2. arcus senilis
3. corneal ulcer
4. herpetic infection of the eye - Answer 2) arcus senilis
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever,
night sweats, and a cough that has been present for 4 weeks. The diagnostic study to
perform first would be:
1) xray
2) pulmonary function test
3) bronchoscopy
4) H & H - Answer 1) xray (tb-night sweats)
A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort
and fatigue. On physical examination, her lungs are clear bilaterally. There are a
midsystolic click and a grade II/VI systolic murmur at the apex. Further evaluation would
include which of the following?
1) EKG, flat plate of the abdomen, lipid profile
2) Echocardiogram, Doppler, EKG
3) Labs and benzo's
4) EEG, Anxiety Scale, and electrolytes - Answer 2) Echocardiogram, Doppler, EKG
A healthy 84 y/o would like to start an exercise program, what would you do before this
takes place?
1) physical exam
, AANP AGPCNP PSI Test 1 & 2
2) EKG
3) knee xrays
4) PT Stress test - Answer 1) Physical Exam
29 y/o has uncomplicated Chlamydia infection will exhibit:
1) green penile discharge
2) uticartia
3) unremarkable symtpoms
4) penile ulcer - Answer 3) unremarkable symptoms
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
1) spirometry
2) MRI
3) COntract venogra[hy
4) helical CT pulmonary angiograph - Answer 4) helical CT pulmonary angiography.
A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly
irregular R-R interval. This arrhythmia is:
1) atrial flutter
2) atrial fibrillation
3) second degree heart block
4) Wolff-White Syndrome - Answer 2) atrial fibrillation
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central
clearing, located in the inguinal area. The patient has had a severe headache, malaise,
fatigue, and generalized musculoskeletal pain for several days. Pharmacologic
management of this condition includes:
1) Bactrim
2) azithromycin
3) doxycycline (Doryx).
4) metronidazole - Answer 3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme
disease-test with WEstern Blot)
According to the American Diabetes Association, the newest standard for determining
the presence of diabetes mellitus based on fasting plasma sugar level is a value equal
to or greater than:
1) 110 mg/dL.
2) 126 mg/dL.
3) 135
An 88-year-old presents with right-side weakness after being unable to rise unassisted
following a fall to the bathroom floor. History includes aphasia and noncompliance with
hypertension medication regimen. What is the most likely diagnosis?
Left-sided or right-sided CVA? - Answer LEFT-SIDED CVA
Which of the following signs/symtpoms are often associated with headahces due to
intracranial tumor?
1) pain worse laying down, focal neurological signs
2) Hyperflexia, personality change
3) acute onset: hours to days
4) pupillary constriction; stupor - Answer 1) pain worse laying down, focal neurological
signs
Which of the following pharmacotherapeutics would be most important to administer to
a patient who has a corneal abrasion?
1) Timolol
2) Gentamicin ophthalmic
3) Cromolyn optha
4) Olopatadine - Answer 2) Gentamicin ophthalmic (Genoptic)
A 25-year-old presents with the chief complaint of decreased mobility and pain of the
right shoulder exacerbated by movement. The patient reports that he participated in
extensive house painting 24 hours prior to the onset of pain. He denies any trauma.
Passive ROM is intact. No redness or ecchymosis is present. What is the next step to
be taken in order to make a diagnosis?
1) Xray of shoulder
2) Palpate structures around the shoulder.
3) MRI of shoulder
4) EMG - Answer 2) palpate structures
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of
midcycle spotting. She has not missed any doses and uses no other medication. Which
of the following is appropriate?
1) Changing to Ortho-Novum 1/35
2) Discontinue use
3) Providing reassurance
4) Double dose-for two days - Answer 3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the
following is NOT a current recommendation guideline for preventive care in elderly
female patients?
,AANP AGPCNP PSI Test 1 & 2
1) Mammogram and clinical breast exams
2) Fecal Occult blood test and/or sig
3) Rubella serology or vaccination history
4) Pnuemo and influenza vaccines - Answer 3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R
10. The best action is to:
1) initiate passive warming
2) apply a rebreather
3) Perform fluid replacement
4) initiate active warming - Answer 1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How
would you educate this patient on recognizing the signs and symptoms of
hypoglycemia?
1) Edema
2) Tachycardia
3) palpitations
4) sweating - Answer 4) sweating
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of
NSAIDs, stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-
up plan of care would be to:
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
2) continue NSAID, apply an arch support and encourage wt loss and exercise
3) continue NSAID, xray and add a short-leg night splint
4) COntinue NSAID, xray and add a metatarsal bar - Answer 2) continue NSAID, apply
an arch support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
1) nicking of arteriols and viens, and small retinol hemorrages
2) drusen bodies and pale retina
3) pale macula and swollen disk margins
4) microaneurysms and optic disc cupping - Answer 1) nicking of arteriols and viens,
and small retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
3) atrial fibrillation
,AANP AGPCNP PSI Test 1 & 2
4) abnormal T3 suppression - Answer 3) atrial fibrillation
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since
the previous day. The eye was rinsed with over-the-counter eyewash, without relief. The
patient denies visual disturbances or drainage. In formulating a plan of care, the nurse
practitioner would FIRST:
1) send to ophthalmologists
2) florescreen staining
3) test visual field
4) prescribe eyedrops - Answer 3) test visual field
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical
examination, the nurse practitioner notes the presence of a gray band of opacity in the
cornea that encircles the iris. The band is 1.0-1.5 mm wide. This finding is most
consistent with a diagnosis of a/an:
1. corneal abrasion
2. arcus senilis
3. corneal ulcer
4. herpetic infection of the eye - Answer 2) arcus senilis
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever,
night sweats, and a cough that has been present for 4 weeks. The diagnostic study to
perform first would be:
1) xray
2) pulmonary function test
3) bronchoscopy
4) H & H - Answer 1) xray (tb-night sweats)
A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort
and fatigue. On physical examination, her lungs are clear bilaterally. There are a
midsystolic click and a grade II/VI systolic murmur at the apex. Further evaluation would
include which of the following?
1) EKG, flat plate of the abdomen, lipid profile
2) Echocardiogram, Doppler, EKG
3) Labs and benzo's
4) EEG, Anxiety Scale, and electrolytes - Answer 2) Echocardiogram, Doppler, EKG
A healthy 84 y/o would like to start an exercise program, what would you do before this
takes place?
1) physical exam
, AANP AGPCNP PSI Test 1 & 2
2) EKG
3) knee xrays
4) PT Stress test - Answer 1) Physical Exam
29 y/o has uncomplicated Chlamydia infection will exhibit:
1) green penile discharge
2) uticartia
3) unremarkable symtpoms
4) penile ulcer - Answer 3) unremarkable symptoms
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
1) spirometry
2) MRI
3) COntract venogra[hy
4) helical CT pulmonary angiograph - Answer 4) helical CT pulmonary angiography.
A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly
irregular R-R interval. This arrhythmia is:
1) atrial flutter
2) atrial fibrillation
3) second degree heart block
4) Wolff-White Syndrome - Answer 2) atrial fibrillation
After a 3-week camping trip, a 17-year-old is seen for a target lesion with central
clearing, located in the inguinal area. The patient has had a severe headache, malaise,
fatigue, and generalized musculoskeletal pain for several days. Pharmacologic
management of this condition includes:
1) Bactrim
2) azithromycin
3) doxycycline (Doryx).
4) metronidazole - Answer 3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme
disease-test with WEstern Blot)
According to the American Diabetes Association, the newest standard for determining
the presence of diabetes mellitus based on fasting plasma sugar level is a value equal
to or greater than:
1) 110 mg/dL.
2) 126 mg/dL.
3) 135
