ANCC AGPCNP PRACTICE QUESTIONS WITH
CORRECT ANSWERS
An 18-year-old female patient is being followed up for acne by the nurse practitioner. During the facial exam,
pap ules 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) - correct answer-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 tak
ing an inhaled short-acting beta2-agonist (SABA) as needed and reports daytime symptoms more than 3
days/week, but not daily, and ni ghttime awakenings 4 to 5 times/week. The patient's forced expiratory
volume (FEV1) is 80% of predi cted. 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 - correct answer-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 s almeterol is prescribed if the patient
is at step 4; budesonide with montelukast is an alternative. Cromo lyn 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 anticoagul
ation therapy with warfarin sodium (Coumadin)?
a. Trimethoprim-sulfamethoxazole (Bactrim DS)
b. Carafate (Sucralfate)
c. Losartan (Cozaar)
d. Furosemide (Lasix) - correct answer-a. Trimethoprim-sulfamethoxazole (Bactrim DS).
Warfarin sodium (Coumadin) interacts with Bactrim and will increase the risk of bleeding; therefore, c
oncurrent 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) - correct answer-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" me
dication, 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 herAannual physical. The patient reports feelings of hopeless
ness 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) - correct answer-d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe depression and no history of sui
cidal ideations. Sertraline is not a safe option for patients younger than 24 years of age because of incr
eased 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 - correct answer-
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 t
he 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.
A 68-year-old patient recently prescribed caridopa-
levodopa (Sinemet) tells the nurse practitionerAthat he has been bloated and experiencing difficulty wit
h bowel movements. Which medication will the nurse practitioner consider incorporating into the treat
ment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol - correct answer-d. Polyethylene glycol
, Levodopa, an antiparkinsonian drug, can cause constipation in an older patient. The first-
line treatment for the patient's constipation is osmotic laxatives such as polyethylene glycol. Senna is a
stimulant laxative that is a second-
line treatment for constipation in an older adult. Methylnaltrexone is a peripherally acting mu-
opioid antagonist that acts on the gastrointestinal tract to decrease opioid-
induced constipation. Magnesium-
based laxatives (e.g., magnesium citrate) taken over the long term should be avoided because of the po
tential of toxicity.
A patient recently returned from a trip to Africa and is experiencing 10 to 12 loose stools every day. T
he patient takes metformin every morning and otherwise is in good health. Which medication will the
nurse practitioner prescribe to treat the diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose - correct answer-d. Ciprofloxacin in a single dose
The patient most likely has traveler's diarrhea, given the history of a recent return from another countr
y. The patient's treatment should be based on functional impact of symptoms and not frequency of sym
ptoms, which is not indicated in the question. The patient likely has moderate acute traveler's diarrhea,
which can be treated with loperamide as monotherapy or with adjunctive antibiotic therapy. The patient
is taking metformin daily for diabetes, so risk of precipitating hypoglycemia is lower than with other
oral antidiabetic agents. Because it can be given in a single dose, ciprofloxacin would be the appropriat
e choice for reducing exposure and microbiome colonization disruption. Levofloxacin and ofloxacin re
quire one to three doses. Trimethoprim-
sulfamethoxazole is a sulfonamide and would be appropriate treatment for cyclosporiasis but not giardi
asis, which is the most common parasitic cause of traveler's diarrhea.
A patient newly diagnosed with diabetes reports severe hives and swollen lips after taking Bactrim for
a bladder infection 2 months ago. Which of the following statements is correct?
a. The patient cannot take any pills in the sulfonylurea class
b. The patient can take some of the pills in the sulfonylurea class
c. The patient can take any of the pills in the sulfonylurea class
d. None of the above - correct answer-c. The patient can take any of the pills in the sulfonylurea class
CORRECT ANSWERS
An 18-year-old female patient is being followed up for acne by the nurse practitioner. During the facial exam,
pap ules 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) - correct answer-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 tak
ing an inhaled short-acting beta2-agonist (SABA) as needed and reports daytime symptoms more than 3
days/week, but not daily, and ni ghttime awakenings 4 to 5 times/week. The patient's forced expiratory
volume (FEV1) is 80% of predi cted. 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 - correct answer-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 s almeterol is prescribed if the patient
is at step 4; budesonide with montelukast is an alternative. Cromo lyn 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 anticoagul
ation therapy with warfarin sodium (Coumadin)?
a. Trimethoprim-sulfamethoxazole (Bactrim DS)
b. Carafate (Sucralfate)
c. Losartan (Cozaar)
d. Furosemide (Lasix) - correct answer-a. Trimethoprim-sulfamethoxazole (Bactrim DS).
Warfarin sodium (Coumadin) interacts with Bactrim and will increase the risk of bleeding; therefore, c
oncurrent 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) - correct answer-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" me
dication, 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 herAannual physical. The patient reports feelings of hopeless
ness 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) - correct answer-d. Escitalopram [Lexapro]
Escitalopram is a safe antidepressant for an adolescent who has severe depression and no history of sui
cidal ideations. Sertraline is not a safe option for patients younger than 24 years of age because of incr
eased 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 - correct answer-
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 t
he 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.
A 68-year-old patient recently prescribed caridopa-
levodopa (Sinemet) tells the nurse practitionerAthat he has been bloated and experiencing difficulty wit
h bowel movements. Which medication will the nurse practitioner consider incorporating into the treat
ment plan?
a. Senna
b. Methylnaltrexone
c. Magnesium citrate
d. Polyethylene glycol - correct answer-d. Polyethylene glycol
, Levodopa, an antiparkinsonian drug, can cause constipation in an older patient. The first-
line treatment for the patient's constipation is osmotic laxatives such as polyethylene glycol. Senna is a
stimulant laxative that is a second-
line treatment for constipation in an older adult. Methylnaltrexone is a peripherally acting mu-
opioid antagonist that acts on the gastrointestinal tract to decrease opioid-
induced constipation. Magnesium-
based laxatives (e.g., magnesium citrate) taken over the long term should be avoided because of the po
tential of toxicity.
A patient recently returned from a trip to Africa and is experiencing 10 to 12 loose stools every day. T
he patient takes metformin every morning and otherwise is in good health. Which medication will the
nurse practitioner prescribe to treat the diarrhea?
a. Levofloxacin daily
b. Ofloxacin BID
c. Trimethoprim-sulfamethoxazole BID
d. Ciprofloxacin in a single dose - correct answer-d. Ciprofloxacin in a single dose
The patient most likely has traveler's diarrhea, given the history of a recent return from another countr
y. The patient's treatment should be based on functional impact of symptoms and not frequency of sym
ptoms, which is not indicated in the question. The patient likely has moderate acute traveler's diarrhea,
which can be treated with loperamide as monotherapy or with adjunctive antibiotic therapy. The patient
is taking metformin daily for diabetes, so risk of precipitating hypoglycemia is lower than with other
oral antidiabetic agents. Because it can be given in a single dose, ciprofloxacin would be the appropriat
e choice for reducing exposure and microbiome colonization disruption. Levofloxacin and ofloxacin re
quire one to three doses. Trimethoprim-
sulfamethoxazole is a sulfonamide and would be appropriate treatment for cyclosporiasis but not giardi
asis, which is the most common parasitic cause of traveler's diarrhea.
A patient newly diagnosed with diabetes reports severe hives and swollen lips after taking Bactrim for
a bladder infection 2 months ago. Which of the following statements is correct?
a. The patient cannot take any pills in the sulfonylurea class
b. The patient can take some of the pills in the sulfonylurea class
c. The patient can take any of the pills in the sulfonylurea class
d. None of the above - correct answer-c. The patient can take any of the pills in the sulfonylurea class
