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AANP/ANCC Final Exam Questions with Complete Solutions (Latest 2025/2026) GRADED A+
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13 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 - CORRECT ANSWERS A). Right lower lobe crackles 3yo 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 - CORRECT ANSWERS c) The child quickly begins using arm to pick up toy a 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 - CORRECT ANSWERS D)Measles
A 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 - CORRECT ANSWERS A)Augmentin Leading cause of cancer-related death in women? a)cervical b)ovarian c)breast d)lung - CORRECT ANSWERS d)Lung a 27yo male uncomplicated chlamydia infection may exhibit: a)urticaria b)no obvious signs or symptoms c) green mucoid penile drainage d)penile shaft ulcer - CORRECT ANSWERS b) No obvious signs/symptoms common 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 - CORRECT ANSWERS b)start lower dose then taper up
c)dementia d)anemia - CORRECT ANSWERS b. osteoporosis 16 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 - CORRECT ANSWERS d)provide reassurance Polymyalgia Rheumatica (PMR) should be managed by: a)whirlpool tub b)celebrex c) analgesic d)prednisone - CORRECT ANSWERS d)prednisone 54yo male c/o malaise as well as delayed ejaculation. Current medications: atenolol, paxil, hctz, claritin. Which med is most likely to cause ED? a)HCTZ b)atenolol c)paxil d) claritin - CORRECT ANSWERS c) Paxil (paroxetine) 25yo presents with chief complaint of decreased mobility and pain of the right shoulder exacerbated with movement. The patient occupation is painting houses. He reports he recently painted for 24 hours prior to onset of pain. Denies trauma. Passive ROM intact. No visible signs of injury. What should NP do next?
a) Palpate structures around shoulder b)obtain MRI c) Order Xray d) Order EMG - CORRECT ANSWERS a) palpate structures around shoulder 17 yo has never had menses. She is at tanner stage III Physical exam normal with weight appropriate. What is likely diagnosis? a) ovarian dysfunction b) dysmenorrhea c) primary amenorrhea d)secondary amenorrhea - CORRECT ANSWERS C. Primary amenorrhea 12 yo patient has a family history of thalessemia and anemia is stage II presentation and a HCT of 330. What should NP order in addition to CBC? a) hemoglobin electrophoresis b) vitamin b12 level c) 25 hr creatinine clearance d) serum folic acid - CORRECT ANSWERS a)hemoglobin electrophoresis Common bacteria responsible for pneumonia in older patients residing in the community is: a) staph aureus b)pseudomonas c)strep pneumo d)tuberculi - CORRECT ANSWERS c)strep pneumo
Which CN is affected in Bell's palsy? a) 5 b) c) d)4 - CORRECT ANSWERS c) 7(VII) Which CN function together for oculomotor function? a)3,4, b)3,4, c)3& d)4&5 - CORRECT ANSWERS b)3,4, Treatment of "viral" conjunctivitis includes the use of: a) antihistamine/decongestant drops b) antihistamine/mast cell stabilizer drops c) cold compresses d) steroid eyedrop - CORRECT ANSWERS c) cold compress A 42-year-old patient with epistaxis, dilated pupils, tachycardia, and mild euphoria shows symptoms associated with the use of: a) benzodiazepine (Alprazolam) b) cocaine c) morphine (MS Contin) d) oxycodone (OxyContin) - CORRECT ANSWERS B. Cocaine
Temporal arteritis requires immediate treatment in order to prevent: a) blindness in the affected eye b) facial nerve palsy c) transient ischemic attack d) trigeminal neuralgia - CORRECT ANSWERS a)blindness in the affected eye A patient who sustained a myocardial infarction comes to the clinic for a refill of atorvastatin (Lipitor). The family nurse practitioner explains that the medication is prescribed for: a) cancer prevention b) primary prevention c) secondary prevention d) tertiary prevention - CORRECT ANSWERS d) tertiary prevention During cardiac auscultation, a soft first heart sound with a holosystolic apical murmur that radiates to the left axilla suggests: a) aortic stenosis b) mitral regurgitation c) mitral stenosis d) mitral valve prolapse - CORRECT ANSWERS B. Mitral regurgitation The adult-gerontology primary care nurse practitioner evaluates a patient with cold symptoms who reports smoking half a pack of cigarettes a day and shows no interest in quitting. The nurse practitioner's most appropriate approach is to treat the cold symptoms and: (a) advise the patient to stop smoking. (b) prescribe bupropion (Zyban). (c) raise the issue of smoking cessation at the next visit.
The nurse practitioner notes a well-demarcated, dry, rough, tan-colored area that measures 1 cm on the forearm of a retired man who worked as a park ranger. The man says that the lesion has been present for years. The lesion is suggestive of: a) actinic keratosis b) keratoacanthoma c) seborrheic keratosis d) senile lentigo - CORRECT ANSWERS a) actinic keratosis The test of choice for diagnosing iron deficiency anemia is a: a) reticulocyte count b) serum ferritin level c) total iron binding capacity d) transferrin saturation level - CORRECT ANSWERS B. Serum ferritin level In the early stages of iron deficient anemias, blood studies show: (a) macrocytic normochromic (b) microcytic hypochromic (c) normochromic normocytic (d) pancytopenia hypocytic - CORRECT ANSWERS B (Microcytic Anemia) A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical examination is unremarkable. Laboratory results are within normal limits except for a markedly elevated alkaline phosphatase level. The nurse practitioner: a) interprets the findings as normally occurring during a rapid adolescent growth spurt b) obtains a rheumatoid profile because elevated alkaline phosphatase is a sign of early rheumatic fever. c) orders a repeat blood test
d) suspects that the patient has acute pancreatitis - CORRECT ANSWERS a) interprets the findings as normally occurring during a rapid adolescent growth spurt Which type of urinary incontinence is lessened by pelvic floor exercises? a) Functional b) Overflow c) Stress d) Transient - CORRECT ANSWERS c)stress A family nurse practitioner advises a nursing mother who has postpartum mastitis to take antibiotics as prescribed and: a) continue to nurse with both breasts b) pump the unaffected breast with a lactation pump c) take cool showers d) temporarily switch to formula - CORRECT ANSWERS a) continue to nurse with both breasts An adult nurse practitioner evaluates a patient who has been a victim of domestic violence. After the office visit, law enforcement authorities contact the nurse practitioner, requesting information regarding any visible injuries observed during the visit. The nurse practitioner's response is to: (a) call the patient to obtain consent. (b) provide the written record, as requested. (c) refer the request to the office manager. (d) require a court order for release. - CORRECT ANSWERS b) provide the written record, as requested Routine immunization guidelines recommend administering the hepatitis B vaccine at birth and repeating doses at: a) one month and six months.
b) Tuberculosis c) Atypical pneumonia d) lung cancer - CORRECT ANSWERS a) Community Acquired Pneumonia (CAP) 72 y/o with subsequent visit of B/P 180/90 is diagnosed with HTN. PMI of Raynauds phenomenon. which does NP prescribe? a) thiazide b) ACE c) Calcium channel blockers d) ARB - CORRECT ANSWERS c) Calcium Channel Blockers Before an older adult patient initiates pharmacotherapy with a medication that is cleared by the kidneys, a nurse practitioner assesses the patient's: a) blood urea nitrogen level b) creatinine clearance c) specific gravity d) urinary sediment - CORRECT ANSWERS b) creatinine clearance During a well-patient office visit, parents express concern about a behavior change in their child. The child was previously social but now cries and hides if someone approaches, has become more clingy around people, and recently became quite upset when the parents hired a familiar babysitter for the evening. The child is healthy and developing normally. What is the most likely age of this child? a). 3 mo b) 9mo c) 12 mo d)2 yrs - CORRECT ANSWERS b. 9 months
A first-time parent asks how long it will be before a 12-month-old will be able to play kickball and run around outdoors. At which age would you tell the parent the patient should be able to do this? a)12mo b) 15 mo c)2 years d)24 mo - CORRECT ANSWERS d)24 mo A nurse practitioner is teaching the mother of a 15-month-old during a well-patient visit. Which statement demonstrates parent understanding of milestones? a)ride a tricycle b)button clothes c)copy a circle d) use 2-3 word sentences - CORRECT ANSWERS d) use 2-3 word sentences By which age range would the nurse practitioner expect that a pediatric patient is able to walk without assistance? a) 8-10 mo b)12-15 mo c)20-24 mo d)16-18mo - CORRECT ANSWERS d) 16-18 mo A nurse practitioner sees an 18-month-old patient for a well-child visit. Which is an appropriate primary preventive service for this patient? a)tdap b)check serum iron levels c)hep b 3rd dose
d)cluster - CORRECT ANSWERS c)tension A father brought in his son for what he thinks was a seizure at lunch. He first noticed the child staring blankly at him and the child was nonverbal for a short period of time. Then, the child began smacking his lips, which was followed by a loss of consciousness. Which type of seizure would the lip smacking most likely be caused by? a) tonic clonic b)complex partial c)absent d)simple partial - CORRECT ANSWERS b)complex partial All of the following can be causes of delirium versus dementia (gradual memory loss) except: a)infections b)alcohol c)anorexia d)atherosclerosis - CORRECT ANSWERS d)atherosclerosis Which is the best choice for abortive treatment of a migraine in a pregnant woman? a)acetaminophen b)triptan c)inderal d)ergotamine - CORRECT ANSWERS a)acetaminophen A patient presents with unilateral facial paralysis, drooping of the eyelid, and minor drooling, which you recognize as Bell's palsy. Which cranial nerve is affected? a)X b)VII
c)IV d)V - CORRECT ANSWERS b)VII 40-year-old female patient visits the clinic at the end of the day with a unilateral throbbing headache. She states she does not know what could have triggered this headache. During her dietary recall, she shares she ate half a jar of pickles that her husband brought home yesterday. She had both photophobia and phonophobia as well as nausea. Her neurologic exam is WNL. You recognize this as which type of headache? a)tension b)trigeminal neuralgia c)migraine d)cluster - CORRECT ANSWERS c)migraine Which of the following medications is an example of prophylactic daily therapy for migraine headaches, which are occurring 3-4 times a month? a) propranolol b) triptan c)acetaminophen d)aspirin - CORRECT ANSWERS a)propanolol Which of the following herbal treatment options for depression has many drug interactions? a)5-HTP b)st. johns wart c)magnesium d)valerian root - CORRECT ANSWERS b) St. Johns Wart Which cranial nerve is the acoustic nerve?
Which type of headache may benefit from 100% oxygen therapy? a)cluster b)tension c)migraine with aura d) migraine without aura - CORRECT ANSWERS a)cluster You test your 35-year-old female patient for H. pylori and her laboratory result comes back positive. Which of the following drugs is not part of a commonly used combination option in the initial treatment of H. pylori? a)omeprazole b)flagyl c)amoxicillin d) carafate - CORRECT ANSWERS d)carafate A patient presents with an unintentional weight loss of 12 lb. over 2 months and pencil-like stools. The patient has not had a colonoscopy for 10 years. Due to these symptoms, which of the following conditions should be ruled out or confirmed first with additional tests? a)ulcerative colitis b)Crohns disease c)diverticulosis d)colon cancer - CORRECT ANSWERS d)colon cancer A patient presents with right upper quadrant pain that started after a fatty meal. Upon examination, Murphy's Sign is positive. Liver function tests are also elevated. Which of the following is the most likely diagnosis? a)pancreatitis b)cholecystitis
c)appendicitis d)Hepatitis - CORRECT ANSWERS b)cholecystitis A patient presents with left lower quadrant pain, nausea, and an elevated sedimentation rate. Which diagnosis is the most likely based on these symptoms? a)pancreatitis b)diverticulitis c)appendicitis d)Hepatitis - CORRECT ANSWERS b)diverticulitis A large amount of bloody diarrhea is the hallmark symptom of which gastrointestinal disease? This disease is also characterized by episodes of symptoms followed by times of remission. a)ulcerative colitis b)diverticulitis c) colon cancer d) IBS - CORRECT ANSWERS a) ulcerative colitis With this sign, you will see superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus caused by retroperitoneal or intraperitoneal blood. a) markle b)cullen c)murphys d) finkelstein - CORRECT ANSWERS b) Cullen An adolescent female patient calls the clinic because she forgot to take her birth control pill yesterday. She is on the last 4 pills of the pack. Which is the best next step for her to take? a) discard pack and start new one