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1 / 19 1.If your patient is in the catarrhal stage of pertussis, upon examination you would find which of the following Ans>> You would find mild upper respiratory symptoms with cough. And mild conjunctival injection. It is really indistinguishable from the common cold. 2.What would NOT be considered a typical finding in a geriatric patient Ans>> Low frequency hearing loss. A typical finding in a geriatric patient would be a high frequency hearing loss.The speaking voice is high frequency. Degenerative changes of the ossicles, fewer auditory neurons and atrophy of the hair cells results in sensorineural hearing loss. 3.Typical findings in a geriatric patient
AANP CERTIFICATION EXAM
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2 / 19 Ans>> Thinner epidermis, dermis and subcu- taneous layers of skin, bright purple-colored patches on the forearms and hands, opaque white ring at the periphery of the cornea 4.Risk factors for age-related macular degeneration: Tobacco use, aging, sun exposure and family history
- A geriatric patient who has a 40 pack-year smoking history complains of painful cramping in the leg muscles that occurs after walking for 20 minutes. After taking a complete history and performing a physical exam, an NP decides that the most likely diagnosis is Ans>> Intermittent claudication
- What is a common cause of acne Ans>> Increase in androgens
- In a 19-year-old who presents with a sore throat and anterior cervical adenopathy, which causative agent would be suspected
4 / 19 14.An adult patient presents with a 2-day history of intermittent stabbing chest pain that worsens with deep breaths. The patient reports a nonproduc- tive cough and no fever for several days, and denies trauma, palpitations or GI symptoms. VS normal. Lungs are clear, heart sounds normal. PE reveals localized chest wall tenderness at the costal margin. EKG and CXR normal. The most likely diagnosis is Ans>> Costchondritis 15.The most common skin cancer is Ans>> Basal cell carcinoma 16.What is true regarding depression in the elderly Ans>> Depression can be in- duced by prescribed and OTC medications 17.Acute otitis media has what characteristics Ans>> Loss of ossicular landmarks on the TM 18.What constellations of symptoms, lasting more than 3 months, is MOST common in fibromyalgia Ans>> Diffuse pain, sleep abnormality, fatigue 19.An adult male is seen for an initial visit. He denies tobacco, drug, or ETOH use. He has a sedentary lifestyle and no family history of DM.VS normal, BMI =
- What diabetes screening tests would an NP order
5 / 19 Ans>> Fasting plasma glucose 25.An adolescent presents for a preparticipation athlete exam. In determining clearance for participation in sports, what should be considered Ans>> Character- istics of the sport 26.Urinary and bowel dysfunction, saddle anesthesia, and leg weakness or foot drop are signs of Ans>> Cauda equina syndrome 27.The NP would suspect what person to be at the highest risk for Rocky Mountain spotted fever Ans>> A 40-year old male who is living in a wooded area raising dogs 28.What condition is associated with the development of type 2 DM Ans>> Delivery of a neonate weighing 9 lb or greater 29.What condition is a risk factor for development of DVT and PE Ans>> Visceral malignancy 30.Research studies indicate that ED in geriatric patients is a common com- plication in Ans>> Vascular disease 31.What neuro signs are characteristic of the patient with AD Ans>> Gait disorder and impaired stereognosis
7 / 19 35.A risk factor postmeno osteoporosis is Ans>> History of tobacco use 36.An NP considering referral of a frail elderly patient for hospice care under- stands that Ans>> Documentation of limited life expectancy is a prerequisite 37.The sound intensity of a grade III/VI hear murmur is typically described as Ans>> Medium intensity 38.What is associated with decreased risk of breast cancer Ans>> Breast feeding 39.An adult patient present with complaints of nausea, fatigue, and myalgia. The patient reports a history of untreated hep B 30 years ago. What hep B serology testing results would indicate that the patient has chronic hepati- tis Ans>> HBsAG = positive, IgM anti-HBc = negative 40.A geriatric patient with anemia, back pain, osteoporosis, and elevated ESR should be evaluated for Ans>> Multiple myeloma 41.An older adult female presents with severe pain. She reports malaise, and periodic itching and burning on her chest wall. PE reveals a small area of hyperesthesia in a
8 / 19 linear fashion. The most likely diagnosis is
10 / 19 Ans>> ACL 47.A geriatric female complains of problems with urination. She reports that whenever she feels the need to urinate, she is unable to "make it to the bathroom in time," and wets herself. Which type of incontinence is most likely Ans>> Urge 48.An early adolescent patient who plays football presents to clinic after a football practice complaining of limping due to anterior left knee pain. The pain has gradually increased over the past 2 weeks but is relieved with rest. The patient denies any trauma, prior surgeries, or medical history. PE reveals
11 / tenderness and swelling of the tibial tubercle and reproduction of pain with resisted knee extension. The H&P exam findings are most consistent with a diagnosis of Ans>> Osgood-Schlatter disease 49.A late adolescent male presents with complaint that his left breast appears larger than the right one. He has a recent 10-lb weight gain and admits to MJ use. On exam, the area is diffuse and nontender, The primary diagnosis is Ans>> Fatty gynecomastia 50.An adult female patient present to the ED for sudden onset of severe lower abdominal pain. She describes the pain as stabbing. She denies nausea, vomiting, fever, or chills. The pain does not radiate. To confirm the diagnosis of an ectopic pregnancy, the NP should order what imaging study Ans>> US 51.A geriatric male, who is a 30-packs a year smoker, present with wheezing and dyspnea. His CXR shows a flattened diaphragm and an increased ret- rosternal chest space.There are decreased vascular markings.The most likely diagnosis is Ans>> COPD 52.A geriatric patient present with a bump on the vulva, associated with pruritis and malodorous drainage. Exam reveals a raised, ulcerated lesion. The
13 / diagnosis is Ans>> Vulvar cancer 53.A pediatric patient presents with a painful, enlarged parotic gland. The most likely diagnosis is Ans>> Mumps 54.A geriatric female presents with tremors and a 20 lb weight loss over 2 months. An NP's lab eval should include a Ans>> TSH and free T- 4 55.A pregnant adult patient is diagnosed with a chlamydial infection at 20 weeks of gestation. What is the most accurate method for confirming this diagnosis Ans>> Nucleic acid amplification test (NAAT) of urine 56.An adult male presents with intermittent retrosternal burning. He has gained 30 lb in the past year. PE results are unremarkable and the EKG is normal. The most likely diagnosis is Ans>> GERD 57.A geriatric male patient is being followed for type 2 DM and HTN. He also has a diagnosis of polycythemia vera and has regular phlebotomies to control this. What statement about this patient is true Ans>> He should avoid dietary iron supplements.
14 / 58.An adult patient reports increasingly frequent migraines, especially upon rising in the morning. The headaches have been successfully managed in the past with APAP and Midrin prn, a neurological etiology has been ruled out. Of the following drugs, which would be recommended for prophylactic migraine management in this case Ans>> Propranolol HCL (Inderal) 40 mg BID 59.Long-term management of a patient with stable COPD includes Ans>> Annual influenza vaccine
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17 / shows the newborn continues with jaundice and the bilirubin level is now 15.2. The NP should Ans>> Prescribe phototherapy for the infant 65.An elderly patient is diagnosed with acute gastritis. The patient stops taking Naproxen and is started on Pepcid. Three weeks later, the patient complains that the anorexia, nausea, and epigastric pain and tenderness have not been relieved. What diagnostic study should be ordered Ans>> Testing for H. pylori 66.A geriatric female was diagnosed with hypothyroidism and started on levothyroxine, 25 ug 1 week ago. She feels tired and wishes to have her medi- cine increased.What is the best response Ans>> Your blood levels should be checked every 6 weeks, as it takes the body several weeks to adjust to the medication 67.An elderly patient with type 2 DM has been well-controlled on glipizide and recently developed stage 1 HTN. After 3 months of lifestyle therapy, the patient is still not at goal BP. What drug class would be the best choice Ans>> ACE inhibitor 68.Smoking MJ leads to what
19 / 69.A geriatric male presents late in the day.The NP suspects bacterial PNA, prescribes abx, and sends the patient home.The next day, the patient returns, but has not improved. What finding would be an indication for hospitaliza- tion Ans>> Confused mental status 70.In a mass casualty situation with presumed anthrax exposure, the drug of choice for prophylaxis is Ans>> Doxycycline
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- A child with refractory retentive encopresis has been treated with a laxative protocol. What is the next step in this patient's treatment plan Ans>> Referral to GI 72.An early adolescent male presents with a history of low-grade fever, headache, and facial rash. Upon exam, the NP finds red papular, vesicular lesions along the right side of the nose. Priority care for this patient should include Ans>> Referral to an ophthalmologist today 73.The preferred treatment for early syphilis is Ans>> Benzathine penicillin G 2.4 million units IM once 74.A 12-year-old child diagnosed with mild persistent asthma has a peak expiratory flow (PEF) of less than 80% of predicted. The most appropriate action would be to Ans>> Add a long-acting beta agonist to the inhaled corticosteroid 75.For treatment of otitis media in a child who is allergic to penicillin, the abx of choice is Ans>> Cefdinir (Omnicef) 76.What medication is prescribed for the treatment of pinworm Ans>> Albendazole (Albenza) 77.An adult patient presents with a burning feeling in the eyes and crusty, inflamed
