AANP/AANP EXAM 2025-2026
1.A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which of
the following medications, if being actively consumed, must be immediately
stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)...ANSWER...D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and
belongs to a drug class known as serotonin agonists. When used in
conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
2.Which of the following is not a symptom of both major depressive
disorder and post-traumatic stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty.
..ANSWER...B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major
depressive disorder (MDD) may also include symptoms of depressed
mood, anhedonia, weight loss or gain, and low energy. However,
hypervigilance (B) is not a symptom associated with this diagnosis.
3.A patient with type 1 diabetes presents for a follow-up visit. He has been
stable on his medication regimen but is worried because he is between
jobs and will be without health insurance coverage for a few months. He
asks if there are less expensive insulin options to get him through this time.
Which of the following would be good options for this patient, given his
circumstance?
Incorrect
A.
Insulin aspart 70/30
1|Page
,B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec...ANSWER...Insulin Isophane
The least expensive insulin type listed in this question is insulin
isophane (C) (neutral protamine Hagedorn insulin). There are also
often pharmacy-specific coupons that can be used on insulin, so
helping patients apply for and navigate these programs can be
instrumental in managing their diabetes. Another inexpensive option
is regular insulin.Insulin analogs (glargine, detemir, degludec, lispro,
and aspart) are significantly more expensive than human insulin
(isophane, regular). Insulins modified by manufacturers, especially
when sold as brand-name medications, tend to be more expensive
due to this modification. While analogs offer alternate lengths of
action and convenience, there is no well-documented clinical
evidence that patient outcomes are improved with differing brands.
Therefore, maintaining a patient's blood glucose level through
outcome-focused treatment is more valuable than a process-focused
plan based on medication.
4.A 40-year-old woman with type 2 diabetes presents to the clinic with
concerns of spiking blood sugar between lunch and dinner. She states she
is on a rapid-acting insulin sliding scale and long-acting insulin. Which
change should be implemented to help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
2|Page
,D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
...ANSWER...A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly
dosed with meals and as a sliding scale regimen based on a patient's
glucose prior to eating (preprandial). It is the appropriate insulin to
add as a mealtime dose when patients experience blood glucose
spikes between meals because of its short-acting properties. Peak
time action of insulin aspart is 2 hours with initial effect within the
first 30 minutes, making it an ideal choice to control expected
postprandial glycemic spikes
5.Which of the following conditions is associated with an increased risk for
conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis.
..ANSWER...C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa,
foreign objects in the ear canal, impacted ear wax, tumors, congenital
anomalies, discontinuity of middle ear bones, cholesteatoma, and
tympanic membrane rupture. Sound normally travels down the ear
canal to vibrate the eardrum (tympanic membrane). The eardrum is
connected to three middle ear bones (malleus, incus, and stapes),
which transmit the sound into the inner ear (cochlea). The cochlea is
the organ that changes sound vibrations into a nerve signal that
travels to the brain. The four types of hearing loss are conductive,
sensorineural, mixed, and retrocochlear. Conductive hearing loss
3|Page
, occurs when sound cannot effectively reach the inner ear due to
issue in the outer ear and middle ear.
6.A 23-year-old patient who is pregnant at 28 weeks gestation presents to
the clinic for a routine prenatal checkup. Which fundal height measurement
would warrant a more conclusive assessment with an ultrasound?
A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm...ANSWER...D. 31 cm
After 20 weeks gestation, the fundal height should be measured with
a measuring tape in centimeters and should match the gestational
age. It can be > or < 2 centimeters and still be within normal limits. A
fundal height of 26-30 cm is a normal finding in a patient who is 28
weeks gestation. A result of 31 cm (D) is larger than expected and
should be further evaluated with an ultrasound.
7.A 4-year-old boy presents with ear pain and an erythematous, bulging
tympanic membrane on examination. The nurse practitioner diagnoses him
with acute otitis media. Which of the following are the three most common
bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis,
Staphylococcus aureus
C.
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1.A patient tells the nurse practitioner that she recently started taking the
supplement St. John's wort after reading about its benefits online. Which of
the following medications, if being actively consumed, must be immediately
stopped?
A. Benadryl
B. Famotidine (Pepcid)
C. Metformnin (Glucophage)
D. Sumatriptan (Imitrex)...ANSWER...D. Sumatriptan (imitrex)
Sumatriptan (Imitrex) (D) is a medication used to treat migraines and
belongs to a drug class known as serotonin agonists. When used in
conjunction with St. John's wort, it may increase the risk of serotonin
syndrome, a potentially life-threatening condition.
2.Which of the following is not a symptom of both major depressive
disorder and post-traumatic stress disorder?
A. Difficulty concentrating
B. Hypervigilance
C. Insomnia
D. Irritabilty.
..ANSWER...B. Hypervigilance
In addition to difficulty concentrating, insomnia, and irritability, major
depressive disorder (MDD) may also include symptoms of depressed
mood, anhedonia, weight loss or gain, and low energy. However,
hypervigilance (B) is not a symptom associated with this diagnosis.
3.A patient with type 1 diabetes presents for a follow-up visit. He has been
stable on his medication regimen but is worried because he is between
jobs and will be without health insurance coverage for a few months. He
asks if there are less expensive insulin options to get him through this time.
Which of the following would be good options for this patient, given his
circumstance?
Incorrect
A.
Insulin aspart 70/30
1|Page
,B.
Insulin detemir
C.
Insulin isophane
D.
Insulin degludec...ANSWER...Insulin Isophane
The least expensive insulin type listed in this question is insulin
isophane (C) (neutral protamine Hagedorn insulin). There are also
often pharmacy-specific coupons that can be used on insulin, so
helping patients apply for and navigate these programs can be
instrumental in managing their diabetes. Another inexpensive option
is regular insulin.Insulin analogs (glargine, detemir, degludec, lispro,
and aspart) are significantly more expensive than human insulin
(isophane, regular). Insulins modified by manufacturers, especially
when sold as brand-name medications, tend to be more expensive
due to this modification. While analogs offer alternate lengths of
action and convenience, there is no well-documented clinical
evidence that patient outcomes are improved with differing brands.
Therefore, maintaining a patient's blood glucose level through
outcome-focused treatment is more valuable than a process-focused
plan based on medication.
4.A 40-year-old woman with type 2 diabetes presents to the clinic with
concerns of spiking blood sugar between lunch and dinner. She states she
is on a rapid-acting insulin sliding scale and long-acting insulin. Which
change should be implemented to help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
2|Page
,D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
...ANSWER...A. Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly
dosed with meals and as a sliding scale regimen based on a patient's
glucose prior to eating (preprandial). It is the appropriate insulin to
add as a mealtime dose when patients experience blood glucose
spikes between meals because of its short-acting properties. Peak
time action of insulin aspart is 2 hours with initial effect within the
first 30 minutes, making it an ideal choice to control expected
postprandial glycemic spikes
5.Which of the following conditions is associated with an increased risk for
conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis.
..ANSWER...C. Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa,
foreign objects in the ear canal, impacted ear wax, tumors, congenital
anomalies, discontinuity of middle ear bones, cholesteatoma, and
tympanic membrane rupture. Sound normally travels down the ear
canal to vibrate the eardrum (tympanic membrane). The eardrum is
connected to three middle ear bones (malleus, incus, and stapes),
which transmit the sound into the inner ear (cochlea). The cochlea is
the organ that changes sound vibrations into a nerve signal that
travels to the brain. The four types of hearing loss are conductive,
sensorineural, mixed, and retrocochlear. Conductive hearing loss
3|Page
, occurs when sound cannot effectively reach the inner ear due to
issue in the outer ear and middle ear.
6.A 23-year-old patient who is pregnant at 28 weeks gestation presents to
the clinic for a routine prenatal checkup. Which fundal height measurement
would warrant a more conclusive assessment with an ultrasound?
A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm...ANSWER...D. 31 cm
After 20 weeks gestation, the fundal height should be measured with
a measuring tape in centimeters and should match the gestational
age. It can be > or < 2 centimeters and still be within normal limits. A
fundal height of 26-30 cm is a normal finding in a patient who is 28
weeks gestation. A result of 31 cm (D) is larger than expected and
should be further evaluated with an ultrasound.
7.A 4-year-old boy presents with ear pain and an erythematous, bulging
tympanic membrane on examination. The nurse practitioner diagnoses him
with acute otitis media. Which of the following are the three most common
bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis,
Staphylococcus aureus
C.
4|Page
