2015 AANP Nursing Diagnosis Practice Exam With Answers (75 Solved Questions)

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American Academy of Nurse Practitioners Practice TestThese are retired test questions from previous years.They are similar instructure, but should not necessarily be considered similar in difficulty whencompared with the actual test.Use only as a guide.There are no rationaleswith the answers.1.A nurse practitioner is suturing a simple laceration on an 11 year-old patient.The use of lidocaine withepinephrine is contraindicated in all of the following areasEXCEPTthe:a.Scalpb.Nosec.Fingersd.Earlobe2.A patient who is 28 weeks pregnant reports a single episode of vaginal bleeding.History indicatesnormal prenatal progress to date and the patient denies pain, vaginal itching, or discharge.Which ofthe following is the most appropriate intervention to aid in the diagnosis of this case?a.Nitrazine teste.Non-stress testf.Ultrasoundg.Bimanual cervical examination3.A 40 year-old male presents with a 2-week history of rectal pain and itching.He reports a past historyof constipation and finding spots of bright red blood on the toilet paper several times per week.Rectalexamination reveals a tender, swollen, bluish, ovoid mass.The stool guaiac test is negative. Which ofthe following actions should the nurse practitioner take?a.Refer the patient to a gastroenterologist for a malignancy workup.h.Schedule a colonoscopy to rule out colon cancer.i.Repeat the guaiac test three times and obtain a complete blood count (CBC).j.Prescribe bulk-forming agents and hydrocortisone suppositories.4.A 65-year-old female presents with shoulder and pelvic girdle pain for the past 6 months.She reportsrecent unintentional weight loss.On physical examination, there is pain on ROM, with no weaknessnoted.Laboratory studies show a low hemoglobin and an elevated sedimentation rate.Which of thefollowing is the most likely diagnosis?a.Polymyositisk.Osteoarthritis1ResultsMust get 51/75 to be passingDate2015

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l.Polymyalgia rheumatica.Fibromyalgia5.A patient with type 1 diabetes mellitus who is on NPH and regular insulin split-dosing presents withcomplaints of early morning rise in fingerstick blood glucose.A review of an at-home glucose testreveals increased morning levels.After an increase in the evening insulin dose, the problem worsens.This is most likely an example of:a.Insulin resistancem. Insulin allergyn.The Somogyi effecto.Hyperglycemia-induced hypoglycemia6.A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouththat do not rub off when wiped with a 4x4.The patient should be evaluated for:a.HIV infectionp.Myelodyspastic syndromeq.Congenital lymphoproliferative diseaser.Non-Hodgkin’s lymphoma7.A routine laboratory assessment of a 12-year-old patient with a family history of thalassemia andanemia reveals Tanner stage II presentation and Hct=35%.In addition to a complete blood count(CBC), the nurse practitioner should order which of the following?a.Serum folic acids.Vitamin B12levelt.Hemoglobin electrophoresisu.24-hour urine creatinine8.An 88-year-old male presents with concerns about memory loss.He feels good, takes and aspirin daily,and has no chronic diseases.He lives alone, drives his own car, and manages his financial affairs.Toevaluate his memory, which of the following tests should the nurse practitioner choose?a.Folstein Mini-Mental State Examv.Geriatric Depression Scalew.Minnesota Multiphasic Personality Inventoryx.Myers-Briggs Test9.A 50-year-old male presents with a chief complaint of malaise.Further questioning reveals that hisprimary concern is delayed ejaculation.He is currently taking the following medications: atenolol(Tenormin) 50mg daily, paroxetine (Paxil) 20mg daily, loratidine (Claritin-D) 1 tablet daily, andhydrochlorothiazide (HCTZ) 25mg daily.The most likely cause of the patient’s concern would be”a.Loratidine (Claritin-D)2

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y.Hydrochlorothiazide (HCTZ)z.Atenolol (Tenormin)aa. Paroxetine (Paxil)10. After a 3-week camping trip, an 11-year-old is seen for a target lesion with central clearing, located inthe inguinal area.The patient has had a severe headache, fatigue, and generalized musculoskeletalpain for several days.Pharmacologic management of this condition includes:a.Trimethoprim-sulfamethoxazole (Bactrim)bb. Azithromycin (Zithromax)cc. Metronidazole (Flagyl)dd. Doxycycline (Doryx)11. A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulderexacerbated by movement.The patient reports that he participated in extensive house painting 24hours prior to the onset of pain.He denies any trauma.Passive ROM is intact.No redness ofecchymosis is present.What is the next step that should be taken in order to make a diagnosis?a.Palpate structures around the shoulderee. Obtain an MRI to evaluate the shoulderff.Order an X-ray of the shouldergg. Request and EMG12. A nurse practitioner is evaluating a 40-year-old patient suspected of having a pulmonary embolus.Thepatient complains of anxiety and cough.A stat chest x-ray is normal.Which of the following testsshould the nurse practitioner preform next?a.Spirometryhh. Magnetic resonance imagining (MRI)ii.Contrast venographyjj.Helical CT pulmonary angiography13. A nurse practitioner orders pulmonary rehabilitation for a 75-year-old with COPD.Expected outcomesof this program include all of the followingEXCEPT:a.Enhanced quality of lifekk. Increased lung capacityll.Decreased in-patient hospitalizationsmm.Improved exercise capacity14. Research findings have shown that , in order to improve the longevity of a patient who has COPD, thetreatment choice is:a.Oxygen3

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nn. Anticholinergic drugsoo. Systemic steroidspp. Exercise15. Which of the following is the most serious outcome of Barrett’s esophagus?a.Esophageal adenocarcinomaqq. Gastroesophageal reflexrr.Peptic stricturess. Esophageal varices16. A 39-year-old patient was diagnosed with acute bronchitis in the emergency department and treatedwith acetaminophen, dextromethorphan, and metaproterenol (Alupent).The patient’s history reveals asmoking habit of 1 pack per day.The patient now presents to a nurse practitioner’s office with a feverof 101.2°F (39.4°C) and a cough productive of thick, yellow-green, foul-smelling sputum.The nursepractitioner should encourage smoking cessation and prescribe:a.theophyllinett.A penicillin antibioticuu. An inhalable corticosteroidvv. A macrolide antibiotic17. Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis?a.Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods,and many white blood cellsww.Squamous epithelial cells with clear cytoplasm and distinct borders, many lactobacillus rods,and occasional white blood cellsxx. Organisms about the size of white blood cells with undulating flagellum, occasional lactobacillusrods, and many white blood cellsyy. Hyphae and spores, few lactobacillus rods, and occasional white blood cells18. Which of the following isNOTan indication of preeclampsia?a.Visual disturbanceszz. Glucosuriaaaa.Edema of face and handsbbb.Headaches19. Which of the following gastrointestinal changes is associated with normal aging?a.Decreased production of gastric acidccc.Decreased incidence of gallstones4

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