AANP PMHNP Exam: Complete Questions and Answers, Exams of Health psychology

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AANP PMHNP EXAM

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1. A patient tells the nurse practitioner that she recently started taking the supplement St. John's wort after reading about its benefits online. Which of the following medications, if being actively consumed, must be immediately stopped? A. Benadryl B. Famotidine (Pepcid) C. Metformin (Glucophage) D. Sumatriptan (Imitrex) Answer: D. Sumatriptan (Imitrex) — risk of serotonin syndrome with St. John's wort.
2. Which of the following is not a symptom of both major depressive disorder and post- traumatic stress disorder? A. Difficulty concentrating B. Hypervigilance C. Insomnia D. Irritability Answer: B. Hypervigilance — not typical in MDD.
3. A patient with type 1 diabetes, stable on meds, is worried about insurance. Which less expensive insulin options are appropriate? A. Insulin aspart 70/ B. Insulin detemir C. Insulin isophane D. Insulin degludec Answer: C. Insulin isophane — least expensive human insulin.
4. A 40-year-old woman with type 2 diabetes has post-lunch blood sugar spikes. Which change should be made? A. Add insulin aspart (Novolog) at lunch B. Add insulin detemir at night C. Increase insulin glargine (Lantus) D. Prescribe NPH insulin with dinner Answer: A. Add insulin aspart (Novolog) at lunch — rapid-acting to control postprandial spikes.
5. Which condition is associated with increased risk of conductive hearing loss? A. Acoustic neuroma B. Meniere disease C. Otitis media D. Presbycusis Answer: C. Otitis media — outer/middle ear issues cause conductive loss.
6. For a pregnant woman at 28 weeks, which fundal height warrants ultrasound? A. 26 cm

A. Untreated crisis can cause hypotension and organ failure B. IM hydrocortisone should be carried at all times C. Electrolyte imbalances include hyperkalemia, hyponatremia D. Symptoms related to increased cortisol in blood Answer: D. Symptoms related to increased cortisol — incorrect, Addison's involves cortisol deficiency.

13. A 72-year-old with jaw pain, blurry vision, headache, fever. Next step? A. Inflammatory markers B. Sumatriptan prescription C. Refer for biopsy (temporal arteritis) D. ED for brain bleed Answer: C. Refer for biopsy — suspect temporal arteritis.
14. A 33-year-old post-rotator cuff repair, cultural sensitivity. Which concept? A. Cultural competence B. Ethnocentrism C. Cultural relativism D. Cultural sensitivity Answer: A. Cultural competence
15. Child exposed to pertussis, not vaccinated. Which vaccine today? A. DTaP B. Td C. Tdap D. No vaccine needed Answer: A. DTaP — for unvaccinated children.
16. Suspicion of papilledema, which patient statement raises concern? A. Sudden eye pain B. Vision worsening over months C. Blurry vision with flashing lights D. Flickering vision lasting seconds — suggests increased intracranial pressure Answer: D. Flickering vision — emergency concern.
17. A man with gonorrhea, positive NAAT, negative chlamydia. Treatment? A. Ceftriaxone 1 g IM; retest in 3 months B. Ceftriaxone 500 mg + azithromycin 1 g; no test of cure needed C. Ceftriaxone 500 mg + azithromycin 1 g; retest in 3 months D. Ceftriaxone 500 mg; no test of cure needed Answer: D. Ceftriaxone 500 mg IM — current guidelines.
18. Headache with bilateral pain, no unilateral features? A. Cluster

B. Migraine C. Temporal arteritis D. Tension headache Answer: D. Tension headache — bilateral, dull, band-like.

19. A patient with 20/200 vision in both eyes, what does this mean? A. OK to drive short distances B. Sees at 200 feet what normal sees at 20 feet C. Will need surgery soon D. Legally blind without glasses Answer: D. Legally blind — vision 20/200 or worse.
20. A woman with increased anxiety, night terrors, hyperawareness. Most likely? A. GAD B. Major depression C. PTSD D. Schizophrenia Answer: C. PTSD
21. A 6-year-old with blistering abdominal lesions, pruritic, fluid-filled. Most likely diagnosis? A. Bullous impetigo B. Herpes zoster C. Nonbullous impetigo D. Varicella Answer: A. Bullous impetigo
22. A woman on tretinoin, increased pustules. Next step? A. Increase dose, follow up in 8 weeks B. Continue tretinoin + tetracycline C. Continue tretinoin + oral isotretinoin D. Stop tretinoin + doxycycline Answer: A. Increase dose, follow up — standard for acne.
23. After her mother’s death, a girl helps with chores and siblings. What concept? A. Family systems theory B. Health belief model C. Lewin change model D. Transition care model Answer: A. Family systems theory
24. Recent trichomoniasis diagnosis, treatment? A. Azithromycin for both B. Ceftriaxone for patient

D. X-ray Answer: B. Synovial fluid aspiration

31. ECG shows reduced R-R interval on inspiration, prolonged on expiration. Most likely? A. Pulsus paradoxus B. Pulmonary flow murmur C. Respiratory sinus arrhythmia D. Sinus bradycardia Answer: C. Respiratory sinus arrhythmia
32. A student explaining a test result to a teen and parent, demonstrating which concept? A. Collaboration B. Dignity and respect C. Information sharing D. Participation Answer: C. Information sharing
33. A child with rash starting as one lesion, spreading to multiple, itchy, scaly. Most likely? A. Topical antihistamine + antifungal B. Needs dermatology referral C. Keep covered, contagious D. May take months to resolve Answer: D. May take months — pityriasis rosea.
34. Chest X-ray shows cardiomegaly. Diagnostic feature? A. >50% cardiothoracic ratio B. Double density sign C. Rounded apex D. Upward displaced diaphragm Answer: A. >50% ratio
35. Second-degree AV block, medication to stop? A. Amlodipine B. Chlorthalidone C. Diltiazem D. Losartan Answer: C. Diltiazem — contraindicated in AV block.
36. An elderly with new confusion, tremor, difficulty concentrating. Initial step? A. Blood glucose B. CT for stroke

C. Mini-Mental exam D. UTI dipstick Answer: A. Blood glucose — check hypoglycemia.

37. Latent TB, treatment? A. Isoniazid + rifampin combo (D) B. Isoniazid alone C. Rifampin alone D. Isoniazid + rifampin for 3 months (D) — most common.
38. Navicular (scaphoid) fracture, best imaging? A. X-ray immediately B. Repeat in 1-2 weeks — often negative early C. MRI or CT for early detection D. Bone scan Answer: C. MRI or CT — more sensitive early.
39. Medicare part for dialysis? A. Part A B. Part B C. Part C D. Part D Answer: B. Part B
40. Patient considering quitting smoking, stage of change? A. Action B. Contemplation C. Maintenance D. Preparation Answer: D. Preparation — actively planning.
41. Lipid profile screening interval? A. Every 5 years unless risk factors B. Every year C. Every 2 years D. Every 10 years Answer: A. Every 5 years — unless high risk.
42. When to check lipids if stabilized? A. Monthly B. Every 1-3 months, then annually C. Every 2 years D. Every 10 years Answer: B. Every 1-3 months, then annually

B. Bradycardia C. Hyperkalemia D. Hypotension only Answer: A. Edema, headaches

50. Which heart sound is loud in heart failure and pregnancy? A. S B. S C. S D. Murmur at apex Answer: A. S
51. In HF patients, which DM medication should be avoided? A. TZDs (e.g., pioglitazone) — can cause edema B. Metformin C. Insulin D. SGLT2 inhibitors Answer: A. TZDs — risk of fluid retention and edema.
52. Which OTC medication should be avoided in HF patients? A. NSAIDs — increase sodium and fluid retention B. Acetaminophen C. Loratadine D. Lisinopril Answer: A. NSAIDs
53. BP to avoid in HF patients? A. CCB — cause edema B. ACE inhibitors C. Beta-blockers D. Diuretics Answer: A. CCB
54. Heart sound heard at the base of the heart? A. S B. S C. S D. S Answer: A. S

55. Heart sounds at the apex? A. S1, S3, S B. S2 only C. S1 only D. S2, S3 only Answer: A. S1, S3, S
56. Diastolic murmurs ("ARMS") include? A. Aortic regurgitation, Mitral stenosis B. Aortic stenosis, Mitral regurgitation C. Tricuspid regurgitation, Pulmonic stenosis D. Mitral regurgitation, Aortic stenosis Answer: A. Aortic regurgitation, Mitral stenosis
57. Systolic murmurs ("MR PAYTON MANNING AS MVP") include? A. Mitral regurgitation, Physiological, Aortic stenosis, MVP B. Mitral stenosis, MVP, Aortic regurgitation C. Mitral prolapse, Aortic regurgitation, MVP D. Mitral regurgitation, Aortic regurgitation, MVP Answer: A. Mitral regurgitation, Physiological, Aortic stenosis, MVP
58. Murmur radiating to the neck? A. Aortic stenosis B. Mitral regurgitation C. Pulmonic stenosis D. Tricuspid regurgitation Answer: A. Aortic stenosis
59. Murmur radiating to the armpit? A. Mitral regurgitation B. Aortic stenosis C. Pulmonic stenosis D. Tricuspid regurgitation Answer: A. Mitral regurgitation
60. Heart condition in pediatrics with a click? A. Marfan syndrome B. Aortic stenosis C. Patent ductus arteriosus D. Ventricular septal defect Answer: A. Marfan syndrome
61. Grade 4 murmur or higher, what is present? A. Palpable thrill

D. ABI > 0.9; hyperlipidemia Answer: A. ABI < 0.9; smoking

68. Stage 1 HTN? A. 130 – 139 / 80– 89 B. 120 – 129 / < C. ≥140 / ≥ D. <120 / < Answer: A. 130–139 / 80– 89
69. Stage 2 HTN? A. ≥140 / ≥ B. 130 – 139 / 80– 89 C. 120 – 129 / < D. <130 / < Answer: A. ≥140 / ≥
70. Goal BP when treating hypertension? A. <130/80 mm Hg B. <140/90 mm Hg C. <150/90 mm Hg D. <120/70 mm Hg Answer: A. <130/80 mm Hg
71. ARBs: medication name ending? A. All end in SARTAN B. All end in PRIL C. All end in PINE D. All end in OLM Answer: A. All end in SARTAN
72. Beta blockers mask signs of? A. Hypoglycemia B. Hyperglycemia C. Hypotension D. Heart failure Answer: A. Hypoglycemia
73. BP meds preferred in pregnant women? A. Nifedipine, Labetalol, Methyldopa ("NLM") B. Thiazides only C. ACE inhibitors D. Beta blockers only Answer: A. Nifedipine, Labetalol, Methyldopa

74. Loop diuretics concern? A. Hypokalemia B. Hyperkalemia C. Hypernatremia D. Hypocalcemia Answer: A. Hypokalemia
75. Rapid doses of Lasix may cause? A. Ototoxicity B. Hypotension C. Hyperglycemia D. Hypercalcemia Answer: A. Ototoxicity
76. Spironolactone education for males? A. Gynecomastia B. Hyperkalemia only C. No side effects D. Decrease in testosterone Answer: A. Gynecomastia
77. Digoxin toxicity symptoms? A. Visual halos, fatigue, bradycardia, weakness B. Tremors, rash, hypertension C. Fever, chills, joint pain D. Hypotension, tachycardia Answer: A. Visual halos, fatigue, bradycardia, weakness
78. Antidote for digoxin toxicity? A. Digibind (Digoxin-specific Fab) B. Vitamin K C. Calcium gluconate D. Atropine Answer: A. Digibind
79. Ulcer with red streaking, foul drainage in diabetic foot? A. MRSA cellulitis — treat with Clindamycin B. Pseudomonas — ciprofloxacin C. E. coli — ciprofloxacin D. Anaerobic — metronidazole Answer: A. Clindamycin
80. Confirmed TB, initial therapy? A. Isoniazid, rifampin, ethambutol

D. Can take place at separate location or home Answer: B. — is incorrect because it states 100%, but actually 85%.

87. A 50-year-old man with hypertension, hyperlipidemia, and mitral valve prolapse presents with elevated BP readings. Which medication should be initiated? A. Chlorthalidone (Thalitone) B. Lisinopril (Prinivil) C. Metoprolol (Lopressor) D. Amlodipine (Norvasc) Answer: A. Chlorthalidone — recommended in this case, especially for Black patients.
88. Which test provides the highest sensitivity for evaluating an anterior cruciate ligament (ACL) tear? A. Anterior drawer test B. Lachman test C. McMurray test D. Valgus stress test Answer: B. Lachman test
89. A 32-year-old woman with persistent cough, night sweats, and chills. NAAT confirms TB. What's the initial treatment? A. Isoniazid, rifampin, ethambutol B. Isoniazid, rifampin, ethambutol, moxifloxacin C. Isoniazid, rifampin, ethambutol, pyrazinamide D. Isoniazid, rifampin, ethambutol, pyrazinamide, streptomycin Answer: C. Isoniazid, rifampin, ethambutol, pyrazinamide
90. A 62-year-old woman with osteoporosis and diabetes has worsening heartburn. First step? A. Increase calcium carbonate (Tums) B. 8 - week course of esomeprazole (Nexium) C. 8 - week course of famotidine (Pepcid) D. Endoscopy referral Answer: B. Esomeprazole 8-week trial
91. Genu varum (bowlegs): maximum valgus occurs at what age? A. 1 year B. 2 years C. 4 years D. 7 years Answer: C. 4 years

92. A girl with Tanner stage 2 is expected to start menses how soon? A. Any day now B. In 3-4 years C. In the next 3 years D. In the next year Answer: C. In about 3 years
93. The study “Enquiring About Tolerance” is an example of what type of study? A. Cross-sectional B. Longitudinal cohort C. Randomized controlled trial (RCT) D. Exposure-outcome tracking Answer: C. RCT
94. Vaginal pH in vulvovaginal candidiasis? A. 2. B. 4. C. 6. D. 8. Answer: B. 4.
95. Which statement about incident to billing is incorrect? A. Created by Medicare, may not apply to other insurers B. Allows reimbursement at 100% of physician’s fee (incorrect statement) C. Physician must see patient first and initiate care D. Can be done at separate office or home Answer: B. — incorrect because it states 100%, but Medicare typically reimburses at 85% for APCs.
96. A 55-year-old man with hypertension and hyperlipidemia has recent BP readings of 135/92, 136/86, 140/84, 139/88. Best plan? A. Continue lifestyle modifications B. Initiate chlorthalidone (Thalitone) C. Initiate lisinopril (Prinivil) D. Initiate metoprolol (Lopressor) Answer: B. Chlorthalidone (Thalitone)
97. Which test has the highest sensitivity for ACL tear? A. Anterior drawer B. Lachman C. McMurray D. Valgus stress Answer: B. Lachman

D. Transition care model Answer: A. Family systems theory

104. Trichomoniasis diagnosis on wet mount? A. Clue cells B. Mobile flagellated protozoa C. Viral inclusions D. Pseudohyphae Answer: B. Flagellated protozoa
105. Turner syndrome caused by? A. Deletion of X chromosome B. Autosomal trisomy C. Y chromosome loss D. Autosomal monosomy Answer: A. Deletion or alteration of X chromosome
106. Vaginal pH in candidiasis? A. 2. B. 4. C. 6. D. 8. Answer: B. 4.
107. Which is incorrect about incident to billing? A. Created by Medicare B. Reimbursement at 100% (incorrect statement) C. Physician must see patient first D. Can be done at separate or home setting Answer: B. (Incorrect because Medicare reimburses at 85%)
108. BP control in a hypertensive patient with PAD? A. Initiate chlorthalidone (Thalitone) B. Initiate lisinopril (Prinivil) C. Initiate amlodipine (Norvasc) D. Start beta blocker Answer: A. Chlorthalidone
109. Highest sensitivity test for ACL tear? A. Anterior drawer B. Lachman C. McMurray D. Pivot shift Answer: B. Lachman

110. Confirmatory test for TB? A. Chest X-ray B. Sputum culture C. TST (>10 mm) D. Interferon gamma release assay (IGRA) Answer: B. Sputum culture
111. A 58-year-old man with new-onset atrial fibrillation. Next step in management? A. Immediate cardioversion B. Rate control with beta-blocker or calcium channel blocker C. Anticoagulation without further assessment D. Observation only Answer: B. Rate control with beta-blocker or calcium channel blocker
112. Most common cause of secondary hypertension? A. Renal artery stenosis B. Primary hyperaldosteronism C. Sleep apnea D. Thyroid disease Answer: A. Renal artery stenosis
113. A 45-year-old woman with a new rash and joint pain, positive ANA. Likely diagnosis? A. Systemic lupus erythematosus B. Rheumatoid arthritis C. Psoriasis D. Dermatomyositis Answer: A. Systemic lupus erythematosus
114. Which medication class can cause drug-induced lupus? A. Hydralazine B. Metformin C. ACE inhibitors D. Beta-blockers Answer: A. Hydralazine
115. A 70-year-old with history of atrial fibrillation on warfarin. INR is 5.0. Next step? A. Hold warfarin and administer vitamin K B. Continue medication C. Increase warfarin dose