ANCC TEST REVIEW QUESTIONS AND ANSWERS
A patient with type1 diabetes mellitus who is NPH and regular insulin split dosing
present with complains of early morning rise finger-stick 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
b) Insulin Allergy
c) The Somogyi Effect
d) Hyperglycemia-induced hypoglycemia. - Answers -a) The Somogyi Effect
A 25-years-old present with a chief complaint of decreased mobility and pain of the right
shoulder exacerbated by movements. 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?
a) Palpate the structure around the shoulder
b) Obtain an MIR to evaluate the shoulder
c) Order and X-Ray of the shoulder
d) Request an EMG
Apply SOAPE - Answers -a) Palpate the structure around the shoulder
Apply SOAPE
An 88 year-old male presents with concerns about memory loss .He feels good, takes
aspirin daily ,and has no chronic diseases ,he drives his own car ,and manages his
financial affairs .To evaluate his memory ,which of the fallowing tests would you
choose?
a) Folstein Mini- Mental-State Examination.
b) Geriatric Depression Scale
c) Minnesota Multiphasic personality inventory
d) Myers -Briggs Test - Answers -a) Folstein Mini- Mental-State Examination
Nonviral Microorganisms most frequently found to cause acute sinusitis are:
a) Streptococcus pneumonie and Haemophilus influenzae
b) Streptococcus pneumonie and staphylococcus aureus
c) Staphylococcus aureus and Pseudomonas aeruginosa
d) Streptococcus pneumonie and Pseudomonas aeruginosa - Answers -a)
Streptococcus pneumonie and Haemophilus influenzae
A 65-year old female presents with shoulder and pelvic girdle pain for the past 6 months
.She reports recent unintentional weigh loss. On physical examination, there is pain on
,ROM with no weakness noted. Laboratory studies show low hemoglobin and elevated
sedimentation rate.Which of the fallowing is the most likely diagnosis?
a) Polymyosistis
b) Osteoarthritis
c) Polymyalgia rheumatic
d) Fibromyalgia - Answers -c) Polymyalgia rheumatic
A 17 year-old female has never had her menses. She is at tanner stage III of sexual
development. Her physical and her weight is appropriate for her age and height. What is
the most likely diagnosis?
a) Secondary amenorrhea
b) Primary amenorrhea
c) Dysmenorrhea
d) Ovarian digenesis - Answers -b) Primary amenorrhea
A nurse practitioner is suturing a simple laceration on a 11-year old patient. The use of
lidocaine with epinephrine is not used in the following areas except the:
a) Scalp
b) Nose
c) Fingers
d) Earlobe - Answers -a) Scalp
Which of the following is not an indication of preeclampsia?
a) Visual disturbance
b) Glycosuria
c) Edema of face and hands
d) Headaches - Answers -b) Glycosuria
A 10- month-old presents with a rash, runny nose, and cough. Examination reveals a
cluster of tiny of white papules with an erythematous a buccal mucosa. What does this
suggest?
a) Scarlet Fever
b) Rubella
c) Erythema infectious
d) Measles - Answers -d) Measles
(Description of the Koplik's Spot")Small white round spots on the base of the buccal
mucosa by the rear molars)
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, many white blood cells
b) Squamous epithelial cells with clear cytoplasm and distinct borders, many
lactobacillus rods, occasional white blood cells
c) Organism about the size of white blood cells with undulating flagellum, occasional
lactobacillus rods, many white blood cells
d) Hyphae and spores, few lactobacillus rods, occasional white blood cells. - Answers -
a) Squamous epithelial cells with stippling appearance and indistinct borders, no
lactobacillus rods, many white blood cells
Which of the followings is typically a sign of acute appendicitis?
a) Periumbilical ecchymosis
b) Rebound tenderness at McBurneys point.
c) A negative Rovsing's sign
d) Pus and mucus in stool - Answers -b) Rebound tenderness at McBurneys point
Which of the following criteria differentiates a transient ischemic attack (TIA) from a
CVA?
a) Focal symptoms
b) Amnesia of incident
c) Slowness of onset
d) Absence of residual symptoms - Answers -d) Absence of residual symptoms
(TIA <24 hour recovery without neurologic deficit/ no brain damage)(CVA > 24 hours
with neurologic deficit)
Assessment findings that would support a diagnosis of mitral regurgitation include:
a) Diastolic murmur with split S1
b) Loud high pitched pansystolic murmur
c) Atrial fibrillation with summation gallop
d) Early diastolic murmur with an S3 wave - Answers -b) Loud high pitched pansystolic
murmur
A 65 years-old male presents to his clinic complaining of increasing fatigue, dyspnea on
exertion ,and ankle edema during the day. He has a history of mild hypertension, for
which he saw his physician years ago. The physician advised the patient to decrease
his salt intake .On physician examination the patient is tachycardia positive for jugular
venous distension, and positive for S3 with a systolic murmur chest X-ray reveals
cardiomegaly with vascular redistribution .The nurse practitioner diagnosis is :
a) Myocardial infarction
b) Pneumonia
c) Congestive heart failure
d) Pleural effusion - Answers -c) Congestive heart failure
, A 67-year old patient with type 2 DM, congestive heart failure (CHF), and a mild artery
disease is currently taking daily hydrochlorothiazide 25 mg daily, glipizide 10 mg daily;
and atorvastatin (Lipitor), 20 mg h.s. Which of the following is an accurate statement
regarding this regimen?
a) The glipizide will increase the risk of potassium depletion....
b) The digoxin will increase the risk of hypoglycemia.
c) The hydrochlorothiazide will predispose the patient to digoxin toxicity
d) The atorvastin will worsen the diabetes - Answers -c) The hydrochlorothiazide will
predispose the patient to digoxin toxicity
A 14 year-old who fell on her outstretched hand complains of proximal forearm pain X-
ray reveals a positive fat pad sign ,and the fully extend the elbow. No definitive bony
changes are seen on X-ray. The most likely working diagnosis is:
a) Upper extremely sprain.
b) Lateral epiconditis.
c) Radial head fracture
d) Olecranon bursitis - Answers -c) Radial head fracture
A 17 year-old female is suspected to have a Polycystic Ovary Syndrome. In addition to
testosterone the most appropriate diagnostic test will be:
a) BUN, creatinine, electrolytes, and denydroeplandrosterone (DHEA).
b) Complete blood count (BUN) ,creatinine and estrone
c) Fasting blood sugar(FBS) ,CBC, BUN and sex hormone binding globuline
d) Follicle stimulating hormone (FSH) luteinizing hormone, prolactin, and thyroid
stimulating hormone (TSH) - Answers -d) Follicle stimulating hormone (FSH) luteinizing
hormone, prolactin, and thyroid stimulating hormone (TSH)
To assess spinal function at S1-level, which deep tendon reflex should be tested?
a) Achilles
b) Cremasteric
c) Anal wink
d) Patelar - Answers -a) Achilles
A 20 year-old male present with a month history of a "bump on my testicle." He reports
being sexually active, with frequent intercourse with multiple partners, which condition
should be suspected?
a) Cancer of testicles
b) Torsion of the testicles
c) Acute epididymitis
d) Gonorrhea - Answers -a) Cancer of testicles