Page 1 of 85
AANP EXAM 2025-2026// AANP EXAM RECENT
VERSION ALL 250 QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES / GRADED A+
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.
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,
,Page 2 of 85
weight loss or gain, and low energy. However, hypervigilance (B) is not a
symptom associated with this diagnosis.
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
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
,Page 3 of 85
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.
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)
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
, Page 4 of 85
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 occurs when sound cannot effectively reach
the inner ear due to issue in the outer ear and middle ear.
AANP EXAM 2025-2026// AANP EXAM RECENT
VERSION ALL 250 QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES / GRADED A+
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.
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,
,Page 2 of 85
weight loss or gain, and low energy. However, hypervigilance (B) is not a
symptom associated with this diagnosis.
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
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
,Page 3 of 85
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.
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)
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
, Page 4 of 85
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 occurs when sound cannot effectively reach
the inner ear due to issue in the outer ear and middle ear.
