AANP AGPCNP PSI Test 1 & 2

An 88-year-old presents with right-side weakness after being unable to rise unassisted following

a fall to the bathroom floor. History includes aphasia and noncompliance with hypertension

medication regimen. What is the most likely diagnosis?

Left-sided or right-sided CVA? : ANS- LEFT-SIDED CVA

Which of the following signs/symtpoms are often associated with headahces due to intracranial

tumor?

1) pain worse laying down, focal neurological signs

2) Hyperflexia, personality change

3) acute onset: hours to days

4) pupillary constriction; stupor : ANS- 1) pain worse laying down, focal neurological signs

Which of the following pharmacotherapeutics would be most important to administer to a patient

who has a corneal abrasion?

1) Timolol

2) Gentamicin ophthalmic

3) Cromolyn optha

4) Olopatadine : ANS- 2) Gentamicin ophthalmic (Genoptic)

A 25-year-old presents with the chief complaint of decreased mobility and pain of the right

shoulder exacerbated by movement. The patient reports that he participated in extensive house

painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No

redness or ecchymosis is present. What is the next step to be taken in order to make a diagnosis?

1) Xray of shoulder

2) Palpate structures around the shoulder.

3) MRI of shoulder

4) EMG : ANS- 2) palpate structures

A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle

spotting. She has not missed any doses and uses no other medication. Which of the following is

appropriate?

1) Changing to Ortho-Novum 1/35

2) Discontinue use

3) Providing reassurance

4) Double dose-for two days : ANS- 3) provide reassurance

According to the Report of the U.S. Preventive Services Task Force, which of the following is

NOT a current recommendation guideline for preventive care in elderly female patients?

1) Mammogram and clinical breast exams

2) Fecal Occult blood test and/or sig

3) Rubella serology or vaccination history

4) Pnuemo and influenza vaccines : ANS- 3) Rubella serology or vaccination history

87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The

best action is to:

1) initiate passive warming

2) apply a rebreather

3) Perform fluid replacement

4) initiate active warming : ANS- 1) initiate passive rewarming

A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would

you educate this patient on recognizing the signs and symptoms of hypoglycemia?

1) Edema

2) Tachycardia

3) palpitations

4) sweating : ANS- 4) sweating

A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs,

stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-up plan of care

would be to:

1) stop NSAID, apply a heel cup and encourage exercise and wt loss.

2) continue NSAID, apply an arch support and encourage wt loss and exercise

3) continue NSAID, xray and add a short-leg night splint

4) COntinue NSAID, xray and add a metatarsal bar : ANS- 2) continue NSAID, apply an arch

support and encourage wt loss and exercise

Fundoscopic exam of Hypertensive patient.

1) nicking of arteriols and viens, and small retinol hemorrages

2) drusen bodies and pale retina

3) pale macula and swollen disk margins

4) microaneurysms and optic disc cupping : ANS- 1) nicking of arteriols and viens, and small

retinol hemorrages

Which of the following is a common presenting feature of hyperthyroidism in the elderly?

1) elevated TSH

2) Thyroid enlargement

3) atrial fibrillation

4) abnormal T3 suppression : ANS- 3) atrial fibrillation

A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the

previous day. The eye was rinsed with over-the-counter eyewash, without relief. The patient

denies visual disturbances or drainage. In formulating a plan of care, the nurse practitioner would

FIRST:

1) send to ophthalmologists

2) florescreen staining

3) test visual field

4) prescribe eyedrops : ANS- 3) test visual field

A 72-year-old patient presents with dry, itchy eyes. During the course of the physical

examination, the nurse practitioner notes the presence of a gray band of opacity in the cornea that

encircles the iris. The band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis

of a/an:

1. corneal abrasion

2. arcus senilis

3. corneal ulcer

4. herpetic infection of the eye : ANS- 2) arcus senilis

A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night

sweats, and a cough that has been present for 4 weeks. The diagnostic study to perform first

would be:

1) xray

2) pulmonary function test

3) bronchoscopy

4) H & H : ANS- 1) xray (tb-night sweats)

A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and

fatigue. On physical examination, her lungs are clear bilaterally. There are a midsystolic click

and a grade II/VI systolic murmur at the apex. Further evaluation would include which of the

following?

1) EKG, flat plate of the abdomen, lipid profile

2) Echocardiogram, Doppler, EKG

3) Labs and benzo's

4) EEG, Anxiety Scale, and electrolytes : ANS- 2) Echocardiogram, Doppler, EKG

A healthy 84 y/o would like to start an exercise program, what would you do before this takes

place?

1) physical exam

2) EKG

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