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ANCC FINAL EXAM | 2025 - 2026 |ACTUAL EXAM QUESTIONS
WITH CORRECT ANSWERS|RATED A+
Q: risk factors for hemorrhagic stroke? C: a fib, hypertension, hyperlipidemia, carotid stenosis
- ANS:->>>A: hypertension HTN - most common cause of intracerebral hemorrhages chronic htn --> microaneurysms of arteries --> leaky/ruptured arteries --> stroke Q: gestational age when fundus felt at pubic symphysis? C: 12, 16, 20, 22 weeks – ANS:->>>A: 12 weeks at pubic symphysis 20 weeks at umbilicus 36 weeks at xiphoid process Q: boys misses school often, complains of abdominal pain, stained underwear is noticed? A: constipation, depression, pinworms – ANS:->>>constipation family theory systems - ANS:->>>individuals are best understood in the context of their families families are best understood when they are viewed as a whole unit, interdependence between members creates cohesiveness and an equilibrium
all parts are interrelated and dependent on each other if one part is damaged, affects the whole family cranial nerve 12: name and function
- ANS:->>>hypoglossal stick out tongue Q: which rash needs treatment within 72 hours and why? C: impetigo, cleft lip, herpes zoster, eczema
- ANS:->>>herpes zoster (shingles) acyclovir most effective when started within 72 hours after the shingles rash appears 11 year old with completed childhood vaccines needs which vaccinations?
- ANS:->>>meningo, HPV x 2, Tdap, Influenza A: diabetes med group that increases intestinal absorption of glucose and decreases post BG? C: DPP-4, GLP-1, SGLT-2, biguanide
- ANS:->>>A: GLP- 1 stimulates insulin release decreases glucagon slows gastric emptying significant decrease of post-meal BG
fish mouth or macrostomia thin upper lip and short philtrum brushfield spots matching descriptions: hordeolum chalazion blepharitis pterygium
- ANS:->>>hordeolum: hurts, purulent itchy pimple on eyelid chalazion: no pain, rubbery node on eyelid blepharitis: crusty red eyelash base pterygium: benign growth on conjunctiva r/t sun matching descriptions: scleroder ma psoriasis roseola scabies
- ANS:->>>scleroderma: overproduction of collagen that leads to tight/hard skin psoriasis: silver plaques/scales roseola (6th): HV6, high fever --> small pink raised bumps on trunk then extremity scabies: severely itchy red-brown vesiculopapular lesions with burrows
Q: 15 y/o male with annular, maculopapular, pruritic hypopigmented rash on trunk area, no fever or adenopathy; what is the rash? C: contact dermatitis, tinea versicolor, scabies, lyme disease
- ANS:->>>tinea versicolor Q: kid with high fever that breaks in 3 days, then abrupt rash appears 1 - 3 days C: 5th dz, 6th dz, rubella - ANS:->>>A: 6th disease: roseola infantum 5th disease: erythema infectiosum: slapped cheek rash followed by lacy rash
cholesteatoma: skin cyst behind ear r/t poor eustachian tube function
Q: what to assess in a child with complications related to frequent otitis media? C: refer for hearing test, tympanic membrane/otoscope assessment - ANS:-
refer for audiometry and hearing test should respond to name by 6 - 9 mo. Q: comparing HbA1c data with other hospitals/organizations - term? C: core competency, risk analysis, peer review, benchmarking - ANS:- benchmarking compare performance within an organization (by a physician or department or over time) hospital-based quality improvement project, APRN reviewing colleague's 4 charts/month to ensure diabetes protocols are met - process called? core competency, force field analysis, peer review, risk analysis - ANS:->>>peer review diagnosis and management of cough, runny nose, malaise, no fever or adenopathy - ANS:->>>common cold (viral rhinitis or URI) rest, hydrate, OTC meds no antibiotics community acquired pneumonia- diagnostic test? - ANS:->>>chest x ray rule out bacterial (lobar), viral (infiltrates), aspiration (diffuse/localized)
C: refer to urologist, cause is stress of work, check PSA - ANS:->>>stress normal weber finding - ANS:->>>no lateralization sound heard equally bilaterally fever, posterior cervical lymphadenopathy, tonsils with white exudate, petechial rash, myalgia - diagnosis? - ANS:->>>infectious mononucleosis cause is EBV "kissing disease"
- monospot heterophile AB test incubate 1 - 2 months no contact sports due to splenic rupture risk oral steroids for airway obstruction Q: married female needs reliable non-hormonal BCM C: birth control pills, condom, nuvaring, copper IUD - ANS:->>>copper IUD TSH 8, treated with levothyroxine 0.25 mcg, recheck TSH 6 - next action? C: wait to change dose, increase dose and recheck - ANS:->>>increase dose and recheck optimal TSH on tx - 1.8 to 3.0 ( N = <5) 80 y/o male with headache and
extreme eye pain what is a danger sign? C: increased tearing, visual acuity changes, nausea - ANS:->>>nausea, vomiting, head pain, blurry vision, halos,
methotrexate warfarin (Heparin is ok) isotretinoin (Vit A derivative) DES
thalidomide live vaccines: MMR, varicella, rota, flumist influenza nasal spray - ANS:->>>nasal spray vaccine = live attenuated can be given to healthy, non-pregnant, 2 - 49 y/o contraindications: aspirin meds, h/o wheezing, immunosuppressed, no spleen, antiviral medication use, chronic diseases negative hepatitis immunity in pregnant woman, correct action? get hep b vaccine, wait till pregnancy ends, nothing, - ANS:->>>get hep b vaccine pregnancy is not a contraindication 3 doses: 1st, 1 mo after, 6 mo after fluoroquinolone adverse effect - ANS:->>>achilles tendon rupture lyme disease - initial presentation joint pain, fatigue, erythema migran - ANS:->>>erythema migrans Q: carbuncle management - pick 3 C: antibiotics, I&D, culture - ANS:-
I&D culture systemic AB (usually staph bacteria) Q: benefit of losing weight for females with PCOS?
no exercise/obesity
BPH first line treatment - ANS:->>>alpha blockers : relaxes bladder neck muscles in prostate to ease urination tamsulosin (flomax), doxazosin GERD can't afford pantoprazole (nexium) and drinks alcohol before bed pick 3: elevate head of bed, avoid eat/drink 3 hours before bed, OTC tums, prescribe h2 receptor blockers, small frequent meals - ANS:->>>1. dietary/lifestyle changes
- antacids or sucralfate
- h2 receptor antagonists (ranitidine)
- PPI (omeprazole) 65 y/o smoker with hypertension, quit smoking 4 years ago- USPSTF recommends which tests to order? echo, EKG, chest xray, stress test - ANS:->>>abd u/s - r/o aortic anuerysm low dose CT - r/o lung cancer mcburneys test - 2 differential diagnoses appendicitis, cholecystitits, diverticulitis, UTI - ANS:->>>appendicitis RLQ pain others: peritonitis, diverticulitis, IBD, ectopic preg, ovarian mass, PID, kidney stone/UTI split S2 - true statement?
heard over 2nd/3rd ICS 2 y/o taking iron for anemia, what test to check for improvement? ferritin depleted, HCT - , hgb - - correct answer patient threatening provider for narcotic prescription, what is next step? - ANS:-
make excuse and leave room to call security parkinsons - term for jerking and turning arm? bradykinesia, cogwheeling - ANS:->>>cogwheeling cranial nerve for tearing - ANS:->>>CN 7 ulcerated cornea, CN 7 bells palsy, eyedrop/patch - correct answer birthweight 6.5 lbs, weight at 12 months? 15 - 16, 19 - 20, 25 - 26, 30 - 31 - ANS:- 19 - 20 triples at 12 months how do oral contraceptives prevent pregnancy? - ANS:->>>prevent implantation by endometrium slough, hormones, inhibit FSH production lower extremity weakness - ANS:->>>numb
80 y/o female concerned with decreased skin elastisity and wrinkles low self esteem, coping, altered thinking of developmental changes - correct answer negative HBsAg, negative anti-HBs : next step? give hep b vaccine, give hep C, give hep A - correct answer which lab to check for xanthelasma? - ANS:->>>lipid panel patient non-fasted before lipid labs, results are abnormal- what is next step? re-do labs and fast, give statin - correct answer DEXA score 2 SD lower than normal - dx? - ANS:->>>osteopenia (SD - 1 to - 2.5) normal (SD 1 or -
- osteoporosis (SD > - 2.5) 40 y/o female 1 SD of DEXA - next action? give estrogen drug raloxifene, check DEXA annually - ANS:-
normal check DEXA annually osteoporosis education weight bearing exercises such as walking, vitamin D fruit/veg, calcium supplements
