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ANCC APRN exam questions & answers
Hydrochlorothiazide (HCTZ) - ANS-Which drug is associated with increased lipoprotein levels? Furosemide (Lasix). Hydrochlorothiazide (HCTZ). Spironolactone (Aldactone). Triamterene (Dyrenium). cerebellar functioning - ANS-The family nurse practitioner asks a patient to perform rapid, alternating movements of the hands to evaluate: cerebellar functioning. cognitive functioning. reflex arc functioning. stereognostic functioning. hepatitis B. - ANS-A 38-year-old patient who is Vietnamese tells the family nurse practitioner that his or her parent died in his or her 40s from liver cancer. The nurse practitioner assesses that the patient is at risk for: hepatitis B. malaria. tularemia. tyrosinemia asking the patient's father if he has any questions regarding his son's care. - ANS-A 55- year-old male patient who is Chinese has a follow-up appointment after cardiac bypass surgery. The patient brings his father with him into the examination room. The family nurse practitioner provides culturally sensitive care by: asking the patient's father if he has any questions regarding his son's care. asking the patient's father to leave the room due to confidentiality issues. performing the examination without commenting to the patient's father. performing the examination, then telling the patient's father the examination findings. long latency period between exposure and disease development. - ANS-A difficult aspect of determining occupational exposure to disease is the: confidentiality of the information within company records. inaccuracy of occupational disease reporting.
long latency period between exposure and disease development. reliance on workers' memories. creating a task force to address scope-of-practice concerns. - ANS-The family nurse practitioner exhibits professional leadership by: adding clinical protocols to the nurse practitioner scope of practice. comparing the workplace roles of the registered nurse and the nurse practitioner. creating a task force to address scope-of-practice concerns. lobbying to eliminate continuing education requirements. evaluation and management code with history, examination and medical decision making - ANS-To comply with regulations for third-party payor reimbursement and documentation, a family nurse practitioner correlates: evaluation and management code with history, examination and medical decision making. health outcomes with physical examination findings and plan of care. medication orders and treatment plan with electronic billing. patient privacy with informed consent. vocational rehabilitation services. - ANS-The family nurse practitioner examines a patient who has sustained a non-work-related injury that interferes with the patient's ability to perform his or her job. The patient does not qualify for medical disability and has a reasonable chance of engaging in a suitable occupation with proper therapy. The nurse practitioner recommends that the patient apply for: Family and Medical Leave Act benefits. home health services. Social Security benefits. vocational rehabilitation services. requesting a referral for evaluation of the larynx. - ANS-A 45-year-old patient who is an opera singer reports progressive hoarseness for the last four weeks. The hoarseness began after a three-hour opera performance. The patient does not smoke and reports no weight loss, upper respiratory infection, dysphagia, or shortness of breath. The family nurse practitioner manages this patient by: ordering a computed tomography scan of the head. ordering an immediate lateral neck x-ray. prescribing systemic antibiotics and cool mist inhalations. requesting a referral for evaluation of the larynx. one month and six months. - ANS-Routine immunization guidelines recommend administering the hepatitis B vaccine at birth and repeating doses at:
Thyroid function study. psoriasis. - ANS-A 40-year-old patient has had a generalized, nonpruritic skin eruption with intermittent exacerbations over the past 10 years. Currently, a well-circumscribed erythematous plaque appears over the patient's left gluteal fold area. The lesion is covered with scales and has some fissuring. The family nurse practitioner makes a diagnosis of: atopic dermatitis. ichthyosis. psoriasis. tinea corporis. mitral regurgitation. - ANS-During cardiac auscultation, a soft first heart sound with a holosystolic apical murmur that radiates to the left axilla suggests: aortic stenosis. mitral regurgitation. mitral stenosis. mitral valve prolapse. Evaluating medication side effect profile. Ordering a thyroid-stimulating hormone level test. Performing a depression screening. - ANS-A 68-year-old male patient reports an unintended weight loss of 15 lbs (6.8 kgs) over the last two months. The patient states that he feels well. His problem list includes depression, tobacco use, hyperglycemia, obesity, and dyslipidemia. The patient's medications are sertraline (Zoloft), metformin (Glucophage), simvastatin (Zocor), and famotidine (Pepcid). The family nurse practitioner initiates which three interventions? Decreasing the statin medication. Increasing the Glucophage dose. Evaluating medication side effect profile. Ordering a thyroid-stimulating hormone level test. Performing a depression screening. 3, 2, 1 - ANS-To determine whether sufficient evidence exists to prescribe glucosamine for a patient who has osteoarthritis (OA) of the knee, the family nurse practitioner reviews three article summaries. Place the article summaries in sequential order of strength of evidence from strongest to weakest:
- Investigators conducted a retrospective review of 1000 charts of patients who were diagnosed with OA and had glucosamine on their medication list. The investigators assessed the pain rating scale at the time the glucosamine was prescribed and compared this score with the pain rating scale three months after the medication had been prescribed. They also reviewed the progress notes and included only patients for whom clinicians stated in the note that the patient took the medication regularly.
- Investigators randomly assigned a group of 1600 patients with OA of the knee to receive either a placebo or glucosamine for six months. The goal was to determine if glucosamine and/or chondroitin treats pain related to OA of the knee and could help prevent structural damage. The study found no benefit for pain relief for the study group compared with the placebo group.
- Researchers evaluated the benefit of glucosamine for osteoarthritis of the hip and/or knee by searching MEDLINE and the Cochrane database for studies that investigated this question. The researchers included only studies that were double-blind, placebo- controlled, randomized trials of at least four weeks duration and tested glucosamine's effectiveness in treating OA in the knee or hip. Fifteen studies were included in the analysis and the investigators applied a statistical formula to evaluate these studies, giving the larger studies more weight. 1, 2, 3 1, 3, 2 2, 1, 3 2, 3, 1 3, 1, 2 3, 2, 1 serve as a handbook to best practice. - ANS-Clinical practice guidelines are designed to: be used in every patient situation. increase variations in clinical care. mandate practice decisions. serve as a handbook to best practice. peer review. - ANS-The family nurse practitioner participates in a hospital-based quality improvement project. The nurse practitioner reviews four charts per month of a nurse practitioner colleague to ensure diabetes protocols are met. This process is a: core competency. force field analysis. peer review. risk analysis. systematic reviews. - ANS-Evidence-based practice in clinical management is grounded in: clinical practice guidelines. cohort studies. expert opinions. systematic reviews.
Applying a heated glass to draw out infection. Burning incense to drive away evil spirits. Giving "hot" foods to counteract a "cold" illness. Using an onion to eradicate a fever. increased MCV and elevated triglyceride levels. - ANS-Laboratory findings for a patient with an alcohol use disorder indicate increased liver function values and: a decreased mean corpuscular volume (MCV) and normal triglyceride levels. elevated potassium and chloride levels. increased MCV and elevated triglyceride levels. increased urine and serum creatinine levels. one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibito - ANS-A new patient arrives at the office for treatment for depression. The patient reports taking simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatric-mental health nurse practitioner eliminates fluoxetine (Prozac), based on the knowledge that the combination can lead to increased plasma levels of the statin, resulting in an increased risk of muscle damage and rhabdomyolysis. The nurse practitioner's reason is that: both medications are CYP450 3A4 inhibitors. both medications are CYP450 3A4 substrates. one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inducer. one medication is a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor. use a survey to elicit patient satisfaction responses. - ANS-The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement at a community mental health clinic. The effective strategy for evaluating the clinic's services is to: analyze the data from epidemiological studies. conduct a root cause analysis. interview patient families. use a survey to elicit patient satisfaction responses. Partial hospitalization program that provides intensive group therapy for rehabilitation. - ANS-Which community-based program is a tertiary level intervention? Educational sessions at the local community mental health center. National Association of Mental Illness meetings that provide education and support. Partial hospitalization program that provides intensive group therapy for rehabilitation. Twelve-step organization support meetings, such as Alcoholics Anonymous. assigns a role for all staff members in improving patient outcomes. - ANS-he psychiatric-mental health nurse practitioner is employed in a newly created attending
role on a psychiatric inpatient unit. To promote an interprofessional environment, the nurse practitioner: discusses the resistance directly with the physicians. assigns a role for all staff members in improving patient outcomes. educates staff members on the role of a psychiatric-mental health nurse practitioner. works with the nurse manager to organize all levels of nursing staff. a plan-do-study-act process. - ANS-The psychiatric-mental health nurse practitioner is tasked with continually improving the quality of care on an inpatient unit. The nurse practitioner implements: a chart review analysis. a root cause analysis. a plan-do-study-act process. failure effect mode analysis Cochrane database. - ANS-To improve treatment and patient outcomes, the psychiatric- mental health nurse practitioner utilizes evidence-based practices. An acceptable resource for evidence-based meta analysis is the: Cochrane database. Medscape database. PubMed database. WebMD database. working with the local chapter of the nurse's professional association. - ANS-The psychiatric-mental health nurse practitioner is concerned about access-to-care issues in the local community and wants to help develop health care policy to help patients access care more effectively. The nurse practitioner knows one of the most effective avenues for developing and advocating for policy is: asking the clinic manager explore options for access. organizing a political protest. working with the local chapter of the nurse's professional association. writing letters to the editor of the local newspaper. interprets the findings as normally occurring during a rapid adolescent growth spurt. - ANS-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 psychiatric-mental health nurse practitioner: interprets the findings as normally occurring during a rapid adolescent growth spurt. obtains a rheumatoid profile because elevated alkaline phosphatase is a sign of early rheumatic fever.
senile lentigo. blindness in the affected eye. - ANS-Temporal arteritis requires immediate treatment in order to prevent: blindness in the affected eye. facial nerve palsy. transient ischemic attack. trigeminal neuralgia. explain to the woman that the discharge is normal. - ANS-The gerontological nurse practitioner performs a speculum examination for a 71-year-old female patient without symptoms, and finds a thin, whitish, nonodorous mucoid discharge high in the patient's vagina. The nurse practitioner's most appropriate intervention is to: explain to the woman that the discharge is normal. prescribe estrogen cream, twice a week. prescribe a topical antifungal medication, applied vaginally each night for one week. recommend the daily use of a vaginal lubricant, for three days. might never completely disappear. - ANS-An 87-year-old patient, who has multiple, fluid-filled and unilateral lesions on an erythematous base that follows a dermatome, reports severe pain and burning at the site. The patient asks how long the pain will last. The gerontological nurse practitioner responds that the pain: might never completely disappear. will disappear in four to six weeks. will disappear in six months to one year. will disappear once the lesions are gone. T4 level is decreased and TSH level is increased. - ANS-For two to three months, an older adult patient has not been taking his or her levothyroxine (Synthroid) as prescribed. The patient now has symptoms of increasing constipation, lethargy, and weakness. The gerontological nurse practitioner anticipates that laboratory tests will show that the patient's: T4 level is decreased and TSH level is increased. T4 level is increased and TSH level is decreased. T4 level is increased and TSH level is unchanged. T4 level is unchanged and TSH level is decreased. prevent or reduce associated health risks. - ANS-The primary reason for reassessing patients' alcohol use is to: advise about safe levels of consumption. evaluate the risk for peripheral neuropathy.
prevent or reduce associated health risks. screen for liver dysfunction. Warfarin (Coumadin). - ANS-Which drug puts an older adult at the highest risk for injury after a fall? Acetaminophen/hydrocodone (Vicodin) Alendronate (Fosamax) Loratadine (Claritin) Warfarin (Coumadin). Tachypnea - ANS-In addition to altered mental status, which is the best early indicator of pneumonia in an older adult? Cough Fever Malaise Tachypnea Stress - ANS-Which type of urinary incontinence is lessened by pelvic floor exercises? Functional Overflow Stress Transient creatinine clearance. - ANS-Before an older adult patient initiates pharmacotherapy with a medication that is cleared by the kidneys, an adult psychiatric and mental health nurse practitioner assesses the patient's: blood urea nitrogen level. creatinine clearance. specific gravity. urinary sediment. view this as a self-care ritual that needs to be preserved. - ANS-An Hispanic patient informs an adult psychiatric and mental health nurse practitioner during a wellness visit that he or she occasionally uses hot chili juice to relieve a "nervous condition." The patient denies any complaints related to this practice. The nurse practitioner's response is to: actively discourage the patient from continuing this treatment. offer a medication to treat the nervous condition. suggest an alternative food to relieve the nervous condition. view this as a self-care ritual that needs to be preserved.
Location and event intensity. Mode of transmission and incubation. Premorbid conditions and surveillance rates. uses the methodology section to support the validity of the study. - ANS-When disseminating research findings in a peer-reviewed journal, the adult-gerontology primary care nurse practitioner: concludes that the study proves the hypothesis. excludes the discussion section, because the conclusion contains this information. recommends incorporating the results directly into clinical practice. uses the methodology section to support the validity of the study. tells the child that the nurse practitioner can discuss the information only with the patient. - ANS-A patient's adult child telephones the adult-gerontology primary care nurse practitioner to inquire about the patient's illness. The patient's child reports that the parent relies upon the child to explain everything to him or her. The nurse practitioner: asks the child to provide a copy of the patient's advance directive document. assures the child that the nurse practitioner can disclose requested information. informs the child that he or she must come to the clinic to discuss the parent's case. tells the child that the nurse practitioner can discuss the information only with the patient. evaluate standards, risks, benefits, and ou - ANS-The adult-gerontology primary care nurse practitioner is appointed to a hospital's multidisciplinary medical ethics review committee. The nurse practitioner's role is to: evaluate standards, risks, benefits, and outcomes. identify how to anticipate and resolve similar future situations. investigate the need for disciplinary action. obtain agreement of all parties with a chosen solution. disseminates research study results to colleagues. - ANS-To improve the quality of clinical practice, the adult-gerontology primary care nurse practitioner: charges a fee for patients who arrive late to clinic appointments. disseminates research study results to colleagues. expresses opinions about alternative therapies with patients who consider such treatments. schedules time during clinic hours to meet with pharmaceutical representatives. open access to care. - ANS-ne effect of using electronic health record applications, such as telemedicine and portable monitoring systems, has been to:
create stand-alone clinics. decrease billable visits. increase risks to patients. open access to care. contacts the patient's adult child. - ANS-The adult-gerontology primary care nurse practitioner evaluates an 80-year-old patient with cognitive deficits, who is unaccompanied by the adult child who typically is present. The patient has urinary symptoms, for which the nurse practitioner considers ordering sulfamethoxazole- trimethoprim (Bactrim). The patient's previous medical record is unavailable. Before prescribing the medication, the nurse practitioner: contacts the patient's adult child. queries the other staff members. relies on the patient's self-report. waits until the patient's chart is available. worried patient whose son is serving in military conflict. - ANS-The adult-gerontology primary care nurse practitioner conducts a small group class on weight management. The nurse practitioner anticipates that the patient who may have the greatest difficulty implementing the counseling is the: extroverted patient raising his or her grandchildren. introverted patient who does not speak in the group. personable patient who lives with his or her children. worried patient whose son is serving in military conflict. advise the patient to stop smoking. - ANS-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: advise the patient to stop smoking. prescribe bupropion (Zyban). raise the issue of smoking cessation at the next visit. recommend that the patient select a low nicotine cigarette. are more likely to be successful at quitting than younger smokers. - ANS-he adult- gerontology primary care nurse practitioner plans to provide smoking cessation education at a community center to older adults and their families. The nurse practitioner designs the program based on knowledge that older adult smokers: are likely to be optimistic about their ability to quit. are more likely to be successful at quitting than younger smokers. have a decreased risk of morbidity and mortality than do younger smokers. receive more instruction to quit from health care providers than younger smokers.
