AANP Board Questions
INR values below __ increase stroke risk sixfold. correct answer2
What allergy contradicts the use of thiazide diuretics? correct answerSulfa
Why should ACE-Is be avoided with renal stenosis? correct answerLeads to ARF
Adverse effects of aldosterone antagonists (Aldactone) correct answerGalactorrhea and hyperkalemia
What are beta blocker indications? correct answerHTN, post-MI< angina, arrhythmias, migraine
prophylaxis, hyperthyroidism
1st line BP med for DM? correct answerACE or ARB
Grapefruit juice should be avoided in what 1st line antihypertensive medication? correct answerCCB
Alternative antibiotic treatment for patients with gram positive baterial infections that are allergic to
PCN: correct answermacrolides
Initial treatment of COPD correct answerIpratropium bromide (anticholinergic)
1st line treatment for gonorrheal infections correct answerRocephin IM
Treatment of anthrax correct answerCipro 500mg BID 7-10 days
Treatment of traveler’s diarrhea correct answerCipro 500mg BID 3 days
What can increase the risk of tendon rupture when on a quinolone? correct answerage and steroids
How long does ASA suppress platelet function? correct answerup to 7 days
What is the FDA category and dose of finasteride? correct answer5mg PO QD and category X
What drug category should not be given with warfarin? correct answersulfa drugs
When should routine screening for breast cancer start? correct answer40
If a patient had only one dose of the hep B vaccine what is recommended? correct answerDo not restart
series; Start with 2nd dose
What is done if a patient has a tetanus-prone wound and an unknown vaccination status? correct
answerAdminister immediate dose of Td and the teatnus immunoglobulin injection
If a person is vaccinated with pneumovax prior to 65 what is recommended? correct answerGive a
booster dose of pneumovax 5 years after initial dose
When should Zostavax be given? correct answerage 60
How far apart should the varicella vaccines be given? correct answer4 weeks
Treatment for otitis externa correct answerCortisporin otic drops
Common bacterial pathogen of otitis externa correct answerPseudomonas
What is cholesteatoma a complication of? correct answerperiorbital sinusitis
What indicates an abnormal Rinne test? correct answerBC>AC
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AANP Practice Questions
A 65-year-old woman presents for a follow-up examination after a new patient visit. She has not seen a
healthcare provider for several years. She is a smoker and her hypertension is now adequately
controlled with medication. Her mother died at age 40 from a heart attack. The fasting lipid profile
shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In addition to starting Therapeutic Lifestyle
Changes, the nurse practitioner should start the patient on:
1.bile acid sequestrant.
- a statin drug.
- a cholesterol absorption inhibitor.
- low-dose aspirin. correct answerA statin drug
The most commonly prescribed medication for mild systemic lupus erythematosus (SLE) is: - azathioprine (AZA).
- belimumab (Benlysta).
- ibuprofen (Advil).
- cyclophosphamide (Cytoxan). correct answeribuprofen (advil)
The most common sign of cervical cancer is: - postcoital bleeding.
- strong odor from vaginal discharge.
- itching in the vaginal area.
- molluscum contagiosum. correct answerpostcoital bleeding
The nurse practitioner prescribes amitriptyline (Elavil) for a patient with neuropathic pain secondary to
diabetes mellitus. On follow-up, the patient complains of urine retention and dry mouth. The
practitioner would: - discontinue amitriptyline and begin ibuprofen (Motrin).
- refer to physical therapy.
- start methocarbamol (Robaxin).
- discontinue amitriptyline and begin gabapentin (Neurontin). correct answerdiscontinue amitriptyline
and begin gabapentin (neurontin)
A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and omeprazole (Prilosec).
The patient complains of headache, abdominal pain, and gas. These symptoms are most likely: - associated with the omeprazole.
- related to the underlying condition.
- the result of the NSAID.
- caused by viral gastroenteritis. correct answerassociated with the omeprazole
The medication of choice for the initial treatment of juvenile rheumatoid arthritis is: - acetaminophen.
- prednisone.
- aspirin.
- ibuprofen. correct answeribuprofen
A 12-year-old with sickle cell anemia has recently experienced a sickle cell crisis and presents for a
follow-up examination after a recent hospitalization. It is most important to continue monitoring
growth, development, and: - white blood cell levels.
- fecal occult blood test.
- hemoglobin levels.
- urine dipsticks. correct answerhemoglobin levels
A 90-year-old female is brought to the clinic by her neighbor. She states that everything is fine, but the
nurse practitioner notes that she has poor hygiene and bruises on her trunk. The neighbor is concerned
that the patient often has no money to buy food, despite income from social security and a coal miner’s
pension. The nurse practitioner suspects abuse. Which of the following is the nurse practitioner
obligated to do next?
- Report the case to the proper authorities.
- Tell the neighbor to check on the woman daily and report back.
- Document the data and report the information to risk management.
- Call the patient’s family and inquire about the concerns. correct answerreport the case to proper
authorities
In most cases, the first manifestation of Alzheimer’s disease is: - impaired judgment.
- decrease in short-term memory.
- disorientation in time and place.
- decrease in long-term memory. correct answerdecrease in short-term memory
The optimal treatment for latent tuberculosis is: - rifampin (Rifadin) for 5 months.
- isoniazid (Nydrazid) for 9 months.
- pyrazinamide for 6 months.
- ethambutol for 6 months. correct answerosioniazid (nydrazid) for 9 months
Unilateral spontaneous serous or serosanguineous discharge from a single duct of a breast is most often
caused by: - intraductal papilloma.
- mucinous breast lesions.
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AANP FNP certification
All diastolic murmurs are pathological. Murmurs Grades I-barely II-audible III- clearly audible. IV- first
time thrill V-Steth edge VI-entire steth. EXAM correct answerIII first time audible, IV first time thrill
Fundal height 12 weeks correct answerFundal Height 12 weeks above symphysis pubis. EXAM
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US
3 month old infant with down syndrome, due to milk intolerance, mom started on goats milk; now has
pale conjunctiva but otherwise healthy. Low HCT. What additional test would you order? correct
answerIron, TIBC
3 months of synthroid, TSH increased, T4 normal, what do you do? correct answerIncrease Medication
3 ways to assess cognitive function in patient with signs/symptoms of memory loss correct answerMini
mental exam
4 month old with strabismus, mom is worried…… correct answertell her it is normal.
4 month old wont keep anything down, what is the main thing you look at? correct answerGrowth chart
6 month old closed anterior fontanel. correct answerXRAY
Abnormal cells on PAP, what do you do next? correct answerRefer for Colposcopy
CAGE ACRONYM correct answerCut down
Annoyed by criticism
Guilty about drinking
Eye opener drink
Causes of tachycardia correct answerFever
Anemia
Hypotension
Cranial nerves responsible for extraocular eye movements correct answerCN 3,4,6
Definition of metabolic syndrome correct answercluster of conditions that increase risk of heart disease,
stroke, diabetes.
diagnose trichomoniasis correct answerwet prep
Elderly presents with atrophic vaginitis, small uterus, palpable 4×5 ovary, what do you do next? correct
answerPelvic US
Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located?
correct answerAnterior septum
Definitive diagnosis of acute bacterial prostatitis correct answerurinalysis and culture
GERD treatment correct answerH2 is first line, give hs
Grade 3 cells on Pap, treatment? correct answerLEEP
excision
Fingernail hematoma treatment? correct answerdrill hole and drain blood?
Increased risk of ectopic pregnancy correct answerSalpingitis, or history of abortion, PID,
Koplick spots correct answerMeasles (rubeola). Grains of salt lesions inside mouth in Measles
Koplick spots correct answerMeasles (rubeola). Grains of salt lesions inside mouth in Measles
Legg-Calve-Perthes Disease correct answerAvascular necrosis of the proximal femoral head
Lipid level of 1500, increased risk for? correct answerPancreatitis
Low HGB, Low HCT, High MCV indicates what? correct answerMacrocytic anemia, B12 Def
Man with BPH, prostate feels on digital exam? correct answerEnlarged, symmetrical, smooth
Man with HTN, CAD, present femoral pulses but absent pedal correct answerArterial Insufficiency
McMurray’s Sign
(+) palpable or audible click while extending with varus stress correct answerMeniscus tears
Lachman’s Test correct answerpivot shift test (ACL tear)
Newborn with foot turned in, what do you do? correct answerrefer to orthopedist
Osgood-Schlatter disease correct answerKnee pain.
inflammation or irritation of the tibia at its point of attachment with the patellar tendon
Patient forgot to start Thanksgiving dinner and husband states she has trouble remembering tasks and
trouble with organization. What is this indicative of? correct answerAlzheimer’s
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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? correct answerLEFT-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 correct answer1) pain worse laying down, focal neurological signs
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 correct answer2) Gentamicin ophthalmic (Genoptic)
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 correct answer2) palpate structures
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 correct answer3) provide reassurance
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 correct answer3) Rubella serology or vaccination history
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 correct answer1) initiate passive rewarming
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 correct answer4) 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 correct answer2) continue NSAID, apply an arch
support and encourage wt loss and exercise
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 correct answer1) nicking of arteriols and viens, and small
retinol hemorrages
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 correct answer3) atrial fibrillation
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 correct answer3) test visual field
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:
- corneal abrasion
- arcus senilis
- corneal ulcer
- herpetic infection of the eye correct answer2) arcus senilis
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 correct answer1) xray (tb-night sweats)
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?
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AANP Exam Review
microcytic hypochromic anemias correct answerMCV <80 MCHC <31
Iron deficiency Anemia
Thalassemia Minor
always check ferritin and serum Fe with microcytic anemias to determine which one
Iron deficiency anemia correct answermicrocytic hypochromic
low: h/h, ferritin, serum Fe, RBC
high: RDW*
periph smear: poikilocytosis (var. shaped RBCs) & anisocytosis (var. sizes RBCs)
s/s: pallor, fatigue, DOE, glossitis, pica, angular cheilitis, koilonycha (spoon shaped nails), tachycardia, HF
tx: ferrous sulfate, incr fiber, fluids, iron rich foods
etiology: blood loss, diet, post gastrectomy, infants chronic intake cows milk <12 mo causes gi bleed
also test for lead poisoning in children
Thalassemia minor correct answermicrocytic hypochromic
normal ferritin and serum iron and RDW**
-genetic disorder: bone marrow produces abnormal hgb – screen fam members of pos pts
Alpha: Asians, Africans
Beta: Mediterranean, Middle Eastern, Africans
dx by hgb electrophoresis
*offer genetic counseling prior to pregnancy
Macrocytic Normochromic Anemias correct answerMCV >100 MCHC 31-37
Pernicious Anemia
Vit B12 deficiency
Folate deficiency
always check both vitB12 and serum folate in macrocytic anemias
Pernicious anemia correct answermacrocytic normochromic / megaloblastic RBCs
autoimmune destruction of parietal cells in fundus – x intrinsic factor production, essential for vit B12
absorption
often cause of vitB12 def
Vitamin B12 deficiency correct answermacrocytic normochromic
B12 <150
high: RDW, low: h/h, RBC
antibody tests: antiparietal AB, anti-IF Ab
24 hr urine for increased MMA (pos for vit b12 def)
Homocysteine level incr in both folate & vitb12 def
s/s: paresthesias of extremities, s/s anemia, decr reflexes, weak hand grip, abn romberg
Tx: B12 injections weekly x 4 weeks then monthly
Folate deficiency anemia correct answermacrocytic normochromic
-lack of folate leading to premature RBC death… caused by dietary deficiency
-folate <4
-no neuro symptoms
tx: incr folate in diet, PO 1-5 mg folate, preg 400mcg/day
Normocytic normochromic anemia correct answerMCV 80-100, MCHC 31-37
Anemia of Chronic Disease
Bone Marrow failure/leukemia
Aplastic Anemia
acute blood loss
Cancer
sickle cell anemia
hgb<12/13, decr RBC and reticulocytes
Aplastic Anemia correct answera normocytic-normochromic type of anemia characterized by the failure
of bone marrow to produce red blood cells
decr WBC, PLT, RBC
s/s: bruising and bleeding, s/s anemia, neutropenia = fungal and bacterial infections
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FNP from practice exam AANP
If patient has right sided weakness, etc. the CVA occurred where correct answerleft side
erythromycin for chlamydia eye infection in infants correct answer…
squamous epithelial cells with stippling appearance, no lactobacilli and many WBCs is correct answerwet
mount that shows BV
the headache of an intracranial tumor correct answerfocal neurological signs and pain worse in supine
position
in order to improve longevity of patient with COPD, tx of choice is correct answeroxygen
which of the following criteria differentiates a TIA from a CVA correct answerabsence of residual
symptoms – TIA sx occur rapidly and then resolve, CVA sx are residual – TIA is temporary block and
usually no residual sx
med of choice for polymyalgia rheumatica correct answerprednisone
helical CT pulmonary angiography correct answertest for PE
electric shock unilateral facial pain correct answertrigeminal neuralgia
sudden vision loss in which person feels like a curtain came down over his eye correct answerretinal
detachment
decreased gastric production with aging correct answer…
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AANP Certification Exam
diverticulum can be an infection of correct answerboth gram – and +
bacteria
Which diuretic should be used for osteoporosis? correct
answerThiazide diuretics:
slows the kidneys excretion of calcium and increases reabsorption
Lachman maneuver correct answerknee instability
tear of ACL
Infections of labia and vagina correct answerbacterial vaginosis,
candidiasis, and trichomoniasis
Chlamydia affects correct answercervix, endometrial lining, fallopian
tubes, pelvic cavity
Acute abdomen symptoms correct answerinvoluntary guarding,
rebound tenderness, board-like abdomen, +obturator and psoas sign
Care of preecplampsia correct answerbed rest, weight and blood
pressure monitoring
Preeclampsia labs correct answerurine protein, serum protein,
creatinine, platelet count
Preeclampsia symptoms correct answerhypertension, proteinuria,
edema (weight gain)
Preeclampsia complications correct answerplacental abruption,
coagulopathy (DIC), renal failure, uteroplacental insufficiency, liver
failure, hypertensive encephalopathy, retinal detachment, pulmonary
edema, seizure, death
community acquired pneumonia
Most common bacteria
least common bacteria
Population
treatment correct answermycolpasma pneumoniae (atypical)
h. influenza, strep pneumoniae
atypical: psuedomonas aeruginosa
college student, school children, military
macrolides: azithromycin, clarithromycin
Mantoux test correct answerPositive: 5mm
Positive for recent immigrants: 10mm
Murphy’s sign correct answerbiliary disorders
deep inspiration by patient and deep palpation RUQ below
costovertebral angle
placenta previa correct answerimplantation of the placenta over the
cervical opening or in the lower region of the uterus
painless bright red blood in the second or third trimester
Order abdominal US
Hashimoto’s is most common in which population correct
answermiddle age to older women
Hypertension Retinopathy correct answerAV nicking and copper or
silver wire arterioles
flame-shaped hemorrhages
threatened abortion correct answervaginal bleeding and cramping, soft
uterus, cervix closed
bacterial vaginosis correct answerfishy odor, milky white or dull gray
discharge
pH > 4.5
20% clue cells
KOH whiff test
squamous cells dotted with lots of bacteria that obscure borders
correct answerclue cells
Lichen sclerosis correct answerskin disease, white spots appear over
time, most common genital and rectal
most common in older woman
itching, discomfort, bleeding
order biopsy
AV valves correct answermitral and tricuspid
semilunar valves correct answerpulmonary and aortic
S1 correct answersystole
closure of AV valves
mitral regurgitation
aortic stenosis
S2 correct answerdiastole
closure of semilunar valves
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AANP-FNP exam
Hegar’s sign correct answerSoftening of lower uterine segment
Chadwick’s sign correct answerBluish color of cervix and vagina at 6-8 weeks
Goodell’s sign correct answerSoftening of cervix at 4+ weeks
Lipids in chronic inactivity correct answerLow HDL
Lipids in under- or untreated hypothyroidism correct answerElevated total cholesterol, TG, and LDL
Lipids in chronic renal insufficiency correct answerElevated total cholesterol and TG
Lipids in alcohol abuse correct answerElevated TG, HDL, and LDL
Vaccines with live attenuated viruses correct answerMMR, varicella, flu-mist(intranasal), Zostavax
Drugs of choice for abdominal infection correct answerBeta lactams + metronidazole (most common);
fluoroquinolones
Drugs of choice for urinary tract infection correct answerFluoroquinolones (except moxi), TMP-SMX,
fluconazole, b-lactams, nitrofurantoin, fosfomycin if pt has many allergies
Drugs of choice for pulmonary infections correct answerMacrolides, resp fluoroquinolones, b-lactams,
doxycycline (MRSA, atypical coverage)
Drugs of choice for skin and soft tissue infections correct answerMRSA: TMP-SMZ, doxycycline,
clindamycin; b-lactams
Drugs of choice for MRSA correct answerVancomycin, daptomycin , linezolid, TMP-SMZ, doxycycline,
ceftaroline
Macrolide drugs correct answerErythromycin, clarithromycin, azithromycin
Macrolide AEs correct answerGI, QT prolongation
Tetracycline uses correct answerMRSA, rocky mtn spotted fever, atypicals (mycoplasma pneumonia,
chlamydia), spirochetes (Lyme), h.pylori
Tetracycline AEs correct answerGI, teeth, hepatic dysfunction, photosensitivity
Fluoroquinolone drugs correct answerCiprofloxacin, levofloxacin, moxifloxacin
Fluoroquinolone uses correct answerUTI (cipro or levo), atypicals (mycoplasma, legionella)
Fluoroquinolones and dairy or vitamins correct answerTake 2 hrs before or 4 hours after (decrease
concentrations)
Metronidazole (Flagyl) uses correct answerC. Diff, vaginitis
Metronidazole AEs correct answerGI, peripheral neuropathy, disulfiram reaction
Nitrofurantoin uses correct answerUTI -not pyelonephritis due to no systemic absorption
Nitrofurantoin AEs, contraindications correct answerPulmonary fibrosis, contraindicated in CrCl <60
(excludes many elderly)
Aminoglycoside drugs correct answerGentamycin, tobramycin
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AANP Exam 3
Mens Health Priapism correct answerpainful erection for 204 hours, ischemi form is medical/surgical
emergency
Testicular cancer correct answerhard fixed, nodule, heaviness or aching, one testicle larger than other,
hydrocele from tumor, painless asymptomatic until Metz, DX gold standard testicular biopsy, US of
testes, refer to urology, for surgical removal (orchiectomy)
Prostate Cancer correct answermost common cancer in men, new onset of low back pain, rectal perianal
area, obstructive voiding symptoms, weak stream, nocturia, risk factor obese and family history, >50
years old, DX routine screening not recommended
Torsion of the appendix testes correct answerblue dot sign, blue colored round mass located on
testicular surface, polyp like structure attached to testicular surface, infarction and necrosis of the
appendix due to torsion, refer to ER
Testicular torsion correct answerabrupt onset extremely painful and swollen red scrotum, n/v, affected
testes higher and closer to body, the cremasteric reflex is missing, > not corrected in <6 hours
permanent damage, if not corrected in 24 hours becomes gangrene, common in males with bell clapper
deformity, TX call 911, US doppler preferred test, manual reduction or surgery, elevated PSA, biopsy of
prostate tissue, PSA level with DRE TX refer to urologist, individualize screen per risk factors
Varicocele correct answerenlargement of the veins within the scrotum, bag of worms, testicular tumor
can cause infertility, DX US of scotum, TX surgical removal or varicosities
Hydrocele correct answerfluid filed sac around testicle, swelling of scrotum, asymptomatic, DX will glow
with transillumination, US of scrotum, TX refer to urologist
Direct inguinal hernias correct answerare found in the Hesselbachs triangle
indirect inguinal hernia correct answerare common on the right side internal ring
Cryptorchidism correct answera testicle that has not moved into the bag of skin below the penis before
birth, maybe one or two, increases risk of testicular cancer
BPH correct answergradual development of urinary obstruction, weak urinary stream, postvoid
dribbling, occasional urinary retention, DX PSA is elevated, prostate enlarged, TX alpha adrenergic
antagonist-terazosin/Hytrin-first for patients with HTN, Flomax, or Proscar shrinks prostate by 50%
Chronic bacterial prostatis correct answer>6 weeks infection, gradual onset, asymptomatic or
UTI,caused by E.coli, suprapubic or perineal pain, irritative voiding, dysuria, nocturia, frequency, DX
boggy prostate, urine and prostatic fluid cultures, three tubes, PSA elevated, TX Bactrim,
fluoroquinolone
Acute prostatis correct answerinfections ascends to urinary tract, E.coli, sudden onset of high fever,
chills, suprapubic pain perineal discomfort, radiates to back to rectum, UTI, symptoms, DX DRE reveals
tender prostate warm and boggy, CBC shows leukocytosis, pyuria, urine culture, TX Ceftriaxone
tetracycline, macrolide, fluoroquinolone, refer if septic shock
Acute bacterial epididymitis correct answerbacteria ascend the urethra, urethritis, reaching epididymitis,
rule out testicular torsion, E coli, swollen red scrotum, unilateral testicular tenderness with urethral
discharge, hydrocele with symptoms of UTI, fever, green colored purulent or serous clear discharge,
Prehn’s sign positive with relief of srotal elevation, DX leukocytosis pyuria, hematuria, Urine culture, test
for gonorrhea/chlamydia TX ceftriaxone, doxycycline, or fluoroquinolone
Erectile dysfunction correct answerd/t vascular insufficiency, neuropathy, medications, smok,ing
alcohol, TX first line TX [hosphodiesterase type 5 inhibitor, Viagra Levitra
Peyronie’s disease correct answerinflammatory disorder of the penis with firbrotic plaques on the tunica
albuginea, penile pain during erection, palpable nodules cause deformity penile erections, may resolve
or require surgery, TX refer to urologist
Balanitis correct answercandidal infection of the glans penis, diabetic or immunocompromised men, TX
topical azole cream, treat partner too
Phimosis correct answerforeskin cannot be pushed back d/t edema, seen in neonates
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AANP
Measles (Rubeola) correct answerWhat RNA virus is associated with cough, coryza, and conjunctivitis
with photophobia, rash that starts on head or face?
Ortolani maneuver correct answertechnique for checking hip integrity. unequal movement suggests the
hip is dislocated
varicocele correct answerenlarged, dilated veins near the testicle
bladder cancer correct answercancerous tumor that arises from the cells lining the bladder; major sign is
hematuria, smoking or industrial chemicals can cause
Roseola infantum correct answerrash starts on the trunk and goes to the extremities
Rash comes out when the fever breaks
endovenous laser therapy (EVLT) correct answertreatment of large varicose veins in the legs in which a
laser fiber is inserted directly into the affected vein to heat the lining within the vein, causing it to
collapse, shrink, and eventually disappear; also called endovenous laser ablation (EVLA)
B12 deficiency correct answerMethylmalonic acid and Homocystein level
cervical dysplasia correct answerthe presence of precancerous changes in the cells that make up the
inner lining of the cervix, white, sharply demarcated lesion of cervix
polycythemia vera correct answergeneral increase in red blood cells (erythremia), pruritis after a shower
L5-S1 correct answerweak plantarflexion
roseacea correct answertopical metronidazole
Constructive pericarditis correct answerPericardial knock
Restrictive Pericarditis correct answerS3
Cluster Headache correct answerUnilateral severe orbital, supraorbital, or temporal pain. More common
in males. Restlessness, tearing of eyes, nasal congestion, rhinnorrhea, fullness of ear, tx-O2 100%
CA 125 correct answerOvarian cancer
Deficiency of Niacin correct answerDermatitis, diarrhea, dementia
Pertussis treatment in children correct answerAzithromycin
HLA-DQA or HLA-DQB correct answergene for susceptibility for DM 1
Glyburide correct answerMost likely sulfa to cause hypoglycemia
Prehn sign correct answerelevation of testicles “feels better, less pressure”
Dengue fever correct answerSupportive Care
Hypoparathyroidism correct answerLow serum mag
Lovastatin correct answerFirst choice for children
Vit D dosage in older adults correct answer800 units/day
Allergy med that won’t cause dizziness correct answerLoratadine
Meriere’s disease first line treatment correct answerAntihistamines of Benzo (diazepam)
Rhinosinutis can cause? correct answerOrbital cellulitis
Hemophilia B correct answerProlong PTT
Fibroadenoma correct answerMost common breast mass from 25-40 years old
Treponema pallidum correct answersyphilis
Wermer syndrome correct answertumors on parathyroid glands
Polycythemia vera correct answercondition characterized by too many erythrocytes; blood becomes too
thick to flow easily through blood vessels, splenomegaly, pruritis after showering
Lyme disease correct answerbullseye rash,
alopecia areata correct answerAutoimmune disorder that causes the affected hair follicles to be
mistakenly attacked by a person’s own immune system; usually begins with one or more small, round,
smooth bald patches on the frontal bone of the scalp.
Biguanides (Metformin) correct answerWorks by suppressing hepatic gluconeogenesis and enhancing
insulin sensitivity of muscle and fat
Sulfonylureas correct answerWork by stimulating insulin secretion from the pancreas
Hutchinson sign correct answerzoster eruption on the tip of the nose
When should screening for diabetes start? correct answer45 years old if no symptoms present
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AANP/ANCC
A). Right lower lobe crackles correct answer13 yo male diagnosed as bronchitis was treated with fluids
and expectant. He returns with fever 102.8, R. pleuretic pain, and green sputum. which of the following
would be an expected finding?
a) Right lower lobe crackles
B) decreased fremitus
c)bilateral wheezing
d)normal percussion
c) The child quickly begins using arm to pick up toy correct answer3yo diagnosed with radial head
subluxation (nursemaid elbow). After closed manipulation the best indicator of successful procedure is:
a) swelling decreases immediately
b) pulses return
c) the child quickly begins using arm to pick up toy
d) a click is felt while the child is attempting to pick up toy
D)Measles correct answera 11mo old presents with a rash, runny clear nose, and cough. During
assessment you note tiny white papules with erythema on the buccal mucousa. What is this suggestive
of?
a)Scarletina
b)Rubella
c)hand, foot, mouth
d) Measles
A)Augmentin correct answerA 17yo complains of 14 day onset of facial pain in maxillary region with
yellow nasal drainage. what is an appropriate initial pharmacological intervention?
a)Augmentin
b)Ceftriaxone(rocephin)
c)Levaquin
d)Erythromycin
d)Lung correct answerLeading cause of cancer-related death in women?
a)cervical
b)ovarian
c)breast
d)lung
b) No obvious signs/symptoms correct answera 27yo male uncomplicated chlamydia infection may
exhibit:
a)urticaria
b)no obvious signs or symptoms
c) green mucoid penile drainage
d)penile shaft ulcer
b)start lower dose then taper up correct answercommon practice rule to follow with initiating
medications in the elderly is:
a)prescribe meds to take in am
b)start lower dose then taper up
c)obtain creatinine clearance for baseline data for those over 70
d)give meds with a full glass of water
b) lower the seizure threshold correct answer12 yo with PMI of seizure is reported by mother that cold
symptoms are present. Denies fever. The NP should advise that a fever may:
a)make seizure medication less effective
b)lower the seizure threshold
c)increase the seizure threshold
d) have no effect on the seizure threshold
c. doxycyline correct answerAccording to the American Thoracic Society/Infectious Disease Society of
American (ATS/IDSA) Consensus guidelines on the Management of Community-Acquired Pneumonia in
Adults, which of the following is the most appropriate antimicrobial for tx of CAP in a:
46 y/o well female with a hx of a bilateral tubal ligation who is macrolide intolerant?
a. clarithromycin
b. amoxicillin
c. doxycyline
d. fosfomycin
c) Doxycycline correct answerafter a 3 wk camping trip, a 11yo presents with a target lesion with central
clearing on the inner left thigh. Chief complaints of headache, fatigue,and generalized muscle pain for
several days. What should NP prescribe?
a)bactrim
b)azithromycin
c) doxycycline
d) metronidazole
b. osteoporosis correct answerDuring development of a treatment plan for a 78 yo with dx
hypothyroidism, the NP needs to be concerned with?
a)renal insufficiency
b)osteoporosis
c)dementia
d)anemia
d)provide reassurance correct answer16 yo currently taking ortho-novum 7/7/7 comes to clinic to report
midcycle spotting. Denies missing doses and is currently not on any other medications. Which is
appropriate?
a)modify usage
b)double her dose x 2 days
c) change to a different medication
d) provide reassurance
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