American Academy of Nurse Practitioners Practice Test These are retired test questions from previous years. They are similar in structure, but should not necessarily be considered similar in difficulty when compared with the actual test. Use only as a guide. There are no rationales with the answers. 1. A nurse practitioner is suturing a simple laceration on an 11 year-old patient. The use of lidocaine with epinephrine is contraindicated in all of the following areas EXCEPT the: a. Scalp b. Nose c. Fingers d. Earlobe 2. A patient who is 28 weeks pregnant reports a single episode of vaginal bleeding. History indicates normal prenatal progress to date and the patient denies pain, vaginal itching, or discharge. Which of the following is the most appropriate intervention to aid in the diagnosis of this case? a. Nitrazine test e. Non-stress test f. Ultrasound g. Bimanual cervical examination 3. A 40 year-old male presents with a 2-week history of rectal pain and itching. He reports a past history of constipation and finding spots of bright red blood on the toilet paper several times per week. Rectal examination reveals a tender, swollen, bluish, ovoid mass. The stool guaiac test is negative. Which of the 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 reports recent unintentional weight loss. On physical examination, there is pain on ROM, with no weakness noted. Laboratory studies show a low hemoglobin and an elevated sedimentation rate. Which of the following is the most likely diagnosis? a. Polymyositis k. Osteoarthritis 1 Results Must get 51/75 to be passing Date 2015 l. Polymyalgia rheumatic a. Fibromyalgia 5. A patient with type 1 diabetes mellitus who is on NPH and regular insulin split-dosing presents with complaints of early morning rise in fingerstick blood glucose. A review of an at-home glucose test reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens. This is most likely an example of: a. Insulin resistance m. Insulin allergy n. The Somogyi effect o. Hyperglycemia-induced hypoglycemia 6. A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouth that do not rub off when wiped with a 4x4. The patient should be evaluated for: a. HIV infection p. Myelodyspastic syndrome q. Congenital lymphoproliferative disease r. Non-Hodgkin’s lymphoma 7. A routine laboratory assessment of a 12-year-old patient with a family history of thalassemia and anemia 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 acid s. Vitamin B12 level t. Hemoglobin electrophoresis u. 24-hour urine creatinine 8. 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. To evaluate his memory, which of the following tests should the nurse practitioner choose? a. Folstein Mini-Mental State Exam v. Geriatric Depression Scale w. Minnesota Multiphasic Personality Inventory x. Myers-Briggs Test 9. A 50-year-old male presents with a chief complaint of malaise. Further questioning reveals that his primary 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, and hydrochlorothiazide (HCTZ) 25mg daily. The most likely cause of the patient’s concern would be” a. Loratidine (Claritin-D) 2 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 in the inguinal area. The patient has had a severe headache, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes: a. Trimethoprim-sulfamethoxazole (Bactrim) bb. Azithromycin (Zithromax) cc. Metronidazole (Flagyl) dd. Doxycycline (Doryx)