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?
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
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
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
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
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?
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
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
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
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
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
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
,3) atrial fibrillation
4) abnormal T3 suppression
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
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
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
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 :
A healthy 84 y/o would like to start an exercise program, what would you do before this
takes place?
, 1) physical exam
2) EKG
3) knee xrays
4) PT Stress test :
29 y/o has uncomplicated Chlamydia infection will exhibit:
1) green penile discharge
2) uticartia
3) unremarkable symtpoms
4) penile ulcer :
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 :
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 :
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 :
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.
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?
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
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
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
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
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?
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
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
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
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
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
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
,3) atrial fibrillation
4) abnormal T3 suppression
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
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
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
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 :
A healthy 84 y/o would like to start an exercise program, what would you do before this
takes place?
, 1) physical exam
2) EKG
3) knee xrays
4) PT Stress test :
29 y/o has uncomplicated Chlamydia infection will exhibit:
1) green penile discharge
2) uticartia
3) unremarkable symtpoms
4) penile ulcer :
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 :
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 :
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 :
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.
