ANCC AGPCNP Practice Exam Questions & Answers

An 18-year-old female patient is being followed up for acne by the nurse practitioner. During the facial exam, papules and pustules are noted mostly on the forehead and the chin areas. The patient has been using over-the-counter topical antibiotic gels and medicated soap daily for 6 months without much improvement. The nurse practitioner will recommend: a. Isotretinoin (Accutane) b. Tetracycline (Sumycin) c. Clindamycin topical solution (Cleocin- T) d. Minoxidil (Rogaine) - b. Tetracycline (Sumycin) First-line treatment for acne vulgaris includes over-the-counter medicated soap and water with topical antibiotic gels. The next step in treatment would be the initiation of oral tetracycline. A young adult presents for reassessment of uncontrolled asthma symptoms. The patient is currently taking an inhaled short-acting beta2-agonist (SABA) as needed and reports daytime symptoms more than 3 days/week, but not daily, and nighttime awakenings 4 to 5 times/week. The patient's forced expiratory volume (FEV1) is 80% of predicted. The nurse practitioner upgrades the patient to the next stage of treatment, which includes: a. Budesonide with formoterol b. Budesonide with montelukast c. Cromolyn or nedocromil d. Fluticasone with salmeterol - a. Budesonide with formoterol. The patient has moved from step 2 to step 3 on the asthma classification scale. Therefore, a low-dose inhaled corticosteroid (ICS) plus long-acting beta-agonist (LABA) such as budesonide with formoterol is an appropriate starting point. Fluticasone with salmeterol is prescribed if the patient is at step 4; budesonide with montelukast is an alternative. Cromolyn and nedocromil have been discontinued in the United States. Which of the following drugs can increase the risk of bleeding in patients who are receiving anticoagulation therapy with warfarin sodium (Coumadin)? a. Trimethoprim-sulfamethoxazole (Bactrim DS) b. Carafate (Sucralfate) c. Losartan (Cozaar) d. Furosemide (Lasix) - a. Trimethoprim-sulfamethoxazole (Bactrim DS). Warfarin sodium (Coumadin) interacts with Bactrim and will increase the risk of bleeding; therefore, concurrent use is contraindicated. 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) - 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). The nurse practitioner is completing a health assessment on a 15-year-old female patient who is in the office for her annual physical. The patient reports feelings of hopelessness and sadness for several months, no history of suicidal ideations, and a struggle with anorexia. The patient scores an 11 on Beck's Depression Inventory. Which antidepressant will the nurse practitioner prescribe? a. Sertraline (Zoloft) b. Lithium carbonate (Eskalith) c. Bupropion (Wellbutrin) d. Escitalopram (Lexapro) - d. Escitalopram [Lexapro] Escitalopram is a safe antidepressant for an adolescent who has severe depression and no history of suicidal ideations. Sertraline is not a safe option for patients younger than 24 years of age because of increased risk of suicidal ideation. Bupropion is an atypical antidepressant and is not a first-line therapy for depression. It is contraindicated in patients with anorexia nervosa. Lithium is indicated for patients with bipolar disorder. Which initial treatment will the nurse practitioner prescribe to a 23-year-old female allergic to sulfa drugs who is diagnosed with acute cystitis? a. Cephalexin (Keflex) 500 mg BID × 5 days b. Ciprofloxacin (Cipro) 250 mg BID × 3 days c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days d. Amoxicillin 500 mg BID × 5 days - c. Nitrofurantoin (Macrobid) 100 mg BID × 5 days Nitrofurantoin can be safely administered to a patient with a sulfa allergy to treat acute cystitis and is the first line of treatment. Cephalexin and amoxicillin are beta-lactam antibiotics that can be prescribed for a patient who has an allergy to sulfa and nitrofurantoin. A fluoroquinolone, such as ciprofloxacin, is recommended for a patient who is allergic to sulfa and beta-lactam drugs or has a sulfa allergy and a known resistance to beta-lactam antibiotics.