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AANP AGPCNP PSI Test 1 & 2 EXAM 2025 ACTUAL EXAM
200 QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
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 ANSWER >>> LEFT-SIDED CVA Which of the following signs/symtpoms are often associated with headahces due to intracranial tumor?
- pain worse laying down, focal neurological signs
- Hyperflexia, personality change
- acute onset: hours to days
- pupillary constriction; stupor - CORRECT ANSWER >>> 1) 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?
- Timolol
- Gentamicin ophthalmic
- Cromolyn optha
- Olopatadine - CORRECT ANSWER >>> 2) 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?
- Xray of shoulder
- Palpate structures around the shoulder.
- MRI of shoulder
- EMG - CORRECT ANSWER >>> 2) 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?
- Changing to Ortho-Novum 1/
- Discontinue use
- Providing reassurance
- Double dose-for two days - CORRECT ANSWER >>> 3) 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?
- Mammogram and clinical breast exams
- Fecal Occult blood test and/or sig
- Rubella serology or vaccination history
Fundoscopic exam of Hypertensive patient.
- nicking of arteriols and viens, and small retinol hemorrages
- drusen bodies and pale retina
- pale macula and swollen disk margins
- microaneurysms and optic disc cupping - CORRECT ANSWER >>> 1) nicking of arteriols and viens, and small retinol hemorrages Which of the following is a common presenting feature of hyperthyroidism in the elderly?
- elevated TSH
- Thyroid enlargement
- atrial fibrillation
- abnormal T3 suppression - CORRECT ANSWER >>> 3) 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:
- send to ophthalmologists
- florescreen staining
- test visual field
- prescribe eyedrops - CORRECT ANSWER >>> 3) 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 ANSWER >>> 2) 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:
- xray
- pulmonary function test
- bronchoscopy
- H & H - CORRECT ANSWER >>> 1) 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?
- EKG, flat plate of the abdomen, lipid profile
- Echocardiogram, Doppler, EKG
- Labs and benzo's
A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly irregular R-R interval. This arrhythmia is:
- atrial flutter
- atrial fibrillation
- second degree heart block
- Wolff-White Syndrome - CORRECT ANSWER >>> 2) atrial fibrillation After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing, located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes:
- Bactrim
- azithromycin
- doxycycline (Doryx).
- metronidazole - CORRECT ANSWER >>> 3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with WEstern Blot) According to the American Diabetes Association, the newest standard for determining the presence of diabetes mellitus based on fasting plasma sugar level is a value equal to or greater than:
- 110 mg/dL.
- 126 mg/dL.
- 135
- whatever - CORRECT ANSWER >>> 2) 126 mg/dl In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves:
- decreased cardiac output.
- loss of vascular tissue elasticity.
- hyperactive baroreceptors - CORRECT ANSWER >>> 2) loss of vascular tissue elasticity A 58-year-old female presents with shoulder and pelvic girdle pain for the past 6 months. She reports recent unintentional weight loss. On physical examination, there is pain on ROM, with no weakness noted. Laboratory studies show a low hemoglobin and an elevated sedimentation rate. Which of the following is the most likely diagnosis?
- Polymyalgia rheumatica
- polymyositis
- osteoarthritis
- Fibromyalgia - CORRECT ANSWER >>> 1) polymyalgia rheumatica An 85-year-old male relates that on the way to his annual physical examination, he suffered a sudden loss of vision in his right eye characterized by "a bunch of lights" and a feeling that "a curtain came down." All of the following would be included in the differential diagnosis EXCEPT:
- opthalmolic migraine
- retinal detachment.
- diabetic retinopathy.
- TIA - CORRECT ANSWER >>> 3) diabetic retinopathy
An 88-year-old female presents with a 3-day history of vertigo. The patient has a past medical history of hypertension controlled with metoprolol, 50 mg daily. She reports that the presenting symptoms are constant, severe, and accompanied by nausea and vomiting. She denies experiencing diplopia, slurring of speech, chest pain, dyspnea, or diaphoresis. She exhibits mild anxiety and reluctance to change position or turn the head. BP = 126/76; P = 78; R = 16/min; and T = 98.2°F (36.8°C). HEENT examination reveals 17 beats of horizontal nystagmus on right lateral gaze; the nystagmus stops after several repetitions of the maneuver. Funduscopic, cardiac, pulmonary, abdominal, and neurologic examination results are normal. The most likely diagnosis is:
- acoustic neuroma
- vestibular neuritis.
- vertibailar insufficiency
- TIA - CORRECT ANSWER >>> 2) vestibular neuritis When initiating thyroid hormone replacement in the older adult, care must be taken to evaluate the patient's:
- coronary status.
- weight
- renal function
- mental state - CORRECT ANSWER >>> 1) coronary status Which of the following would be most appropriate to perform in the initial evaluation of a patient with symptoms of acute prostatitis?
- Prostate-specific antigen (PSA)
- Urinalysis and urine culture
- Scrotal massage and urine sample
- CBC with diff - CORRECT ANSWER >>> 2) urinalysis and urine culture Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis?
- Organisms about the size of white blood cells with undulating flagellum, occasional lactobacillus, many white blood cells
- Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells
- Squamous epithelial cells with stippling appearance and indistinct borders, many lactobacillus rods, few white blood cells - CORRECT ANSWER >>> 2) Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells Which of the following physical findings would best alert a nurse practitioner to the probability of a herniated lumbar disc?
- Positive Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 90°
- Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30°
A manifestation of autonomic neuropathy in a 70-year-old patient with diabetes mellitus is:
- tremors.
- orthostatic hypotension.
- hypertension
- color blindness - CORRECT ANSWER >>> 2) orthostatic hypotension The most common fluid and electrolyte imbalance in patients over 65 years of age is:
- hypokalemia
- due to dehydration.
- Hypercalcemia
- due to fluid overload - CORRECT ANSWER >>> 2) due to dehydration Office spirometry performed with an albuterol nebulizer treatment can confirm a diagnosis of asthma because it indicates:
- a patient has pulmonary fibrosis
- chronic carbon dioxide retension
- if a patient has reversible airway obstruction. - CORRECT ANSWER >>> 3) if a patient has reversible airway obstruction. To assess ability to reason abstractly, you would ask the patient to:
- the meaning of a common proverb
- ask what they would do if there was a fire in the house
- count backwards by 7's - CORRECT ANSWER >>> 1) the meaning of a common proverb A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouth that do not rub off when wiped with a 4 × 4. The patient should be evaluated for:
- lichen planus
- HIV infection.
- lymphoma
- Candida lingua - CORRECT ANSWER >>> 2) HIV infection (hairy luekaplakia-immune) A 70-year-old patient presents with complaints of vague epigastric pain occurring at night, causing early morning awakening, and decreased appetite with early satiety. Significant history includes recent use of ibuprofen for headaches. Rectal examination was negative. While awaiting the results of ordered diagnostic tests, the practitioner should recommend all of the following EXCEPT:
- starting H2 blockers.
- taking off from work until the work-up is complete.
- Reporting nausea/vomiting
- Discontinue NSAIDS - CORRECT ANSWER >>> 2) taking off work until the work-up is complete A 32-year-old patient reports a 6-month history of intermittent symmetrical swelling of the wrists and daily morning stiffness lasting 1 hour or more in and around other joints. What is the most likely diagnosis?
- CV III, IV and VI
- CN III, V, VII - CORRECT ANSWER >>> 2) CV III, IV and VI The management of COPD in the elderly is best guided by:
- pulse oximetry
- arterial blood gases
- radiographic images
- symptomology - CORRECT ANSWER >>> 4) symptomology Which of the following is the most serious outcome of Barrett's esophagus?
- Esophageal adenocarcinoma
- esophageal varices
- GERD
- Stricture - CORRECT ANSWER >>> 1) Esophageal adenocarcinoma Which of the following is most important in enhancing a nurse practitioner's clinical assessment when promoting health behaviors in young adults?
- Personality
- Include the parents with the pateint
- Taking developmental stages into consideration
- Provide a chart of growth physical changes - CORRECT ANSWER >>> 3) Taking developmental stages into consideration
Pulmonary status findings of increased total lung capacity and residual volume in a 74-year-old patient are indicative of:
- emphysema.
- COPD
- chronic bronchitis
- Asthma - CORRECT ANSWER >>> 1) emphysema A 65-year-old patient with hypertension and associated angina requests a flu vaccine. The patient had a pneumococcal vaccine 10 years ago. The most appropriate plan of care would include:
- influenza vaccine, 0.5 mL IM,
- influenza vaccine, 0.5 mL IM, and pneumococcal vaccine, 0.5 mL IM.
- pneumococcal vaccine, 0.5 mL IM. - CORRECT ANSWER >>> 2) influenza vaccine, 0.5 mL IM, and pneumococcal vaccine, 0.5 mL IM. An 87-year-old patient is being treated for major depression with a selective serotonin reuptake inhibitor. Which of the following would have the greatest probability of remaining in the serum long after being discontinued?
- Celexa
- Prozac
- Paxil
- Zoloft - CORRECT ANSWER >>> 2) Fluoxetine (Prozac)
- low fiber diet and referral to GI
- clear liquids and oral antibiotics.
- admit to hospital - CORRECT ANSWER >>> 3) clear liquids and oral antibiotics. A frail elder who is on total bed rest suddenly develops urinary and fecal incontinence. This condition is frequently an indication of:
- dementia.
- fecal impaction.
- cholecystitis.
- parkinsons. - CORRECT ANSWER >>> 2) fecal impaction. A 65-year-old female with diabetes mellitus presents for a routine follow up. BP is 142/88, Hgb A1c is 8.4%, fasting blood glucose is 160 mg/dL, and microalbumin is 60 mg/L (normal < 30 mg/L). In addition to changing the diabetes medications, the nurse practitioner would also ensure that the patient is taking:
- nifedipine 12.5mg daily
- Amlodipine 10mg daily
- benazepril, 10 mg daily.
- atenolol 25mg BID - CORRECT ANSWER >>> 3) benazepril, 10 mg daily. A 67-year-old patient with type 2 diabetes mellitus, congestive heart failure (CHF), and mild coronary artery disease is currently taking digoxin, 0.25 mg daily; hydrochlorothiazide, 25 mg daily; glipizide, 10 mg daily; and atorvastatin (Lipitor), 20 mg h.s. Which of the following is an accurate statement regarding this regimen?
- Glipizide will deplete potassium stores
- The hydrochlorothiazide will predispose the patient to digoxin toxicity.
- atorvastatin will worsen the diabetes - CORRECT ANSWER >>> 2) The hydrochlorothiazide will predispose the patient to digoxin toxicity. An 18-year-old patient presents with complaints of maxillary facial pain and yellow nasal discharge for 14 days. What is the appropriate initial pharmacologic intervention?
- Amoxicillin
- Diphenhydramine
- Doxycycline
- erythromycin - CORRECT ANSWER >>> 1) Amoxicillin Therapy for temporal arteritis would include:
- Tylenol with codiene
- ibuprofen 800mg TID
- prednisone, 60 mg daily PO and re-evaluate in 1 month. - CORRECT ANSWER >>> 3) prednisone, 60 mg daily PO and re-evaluate in 1 month. In addressing suspected domestic violence in an adult relationship, it is appropriate to:
- just do a physical assessment, not social
- make an assessment of battering.
- avoid making a battering assessment, it is legal - CORRECT ANSWER >>> 2) make an assessment of battering.
