an older adult presents with severe abdominal pain the husband reports that earlier in the afternoon
the patients abdominal hernia had been fi
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AANP AGPCNP PRACTICE 2020 Test 2
1. An older adult presents with severe abdominal pain. The husband reports that earlier in the
afternoon, the patient's abdominal hernia had been firm and bulged out 4 inches (10.2 cm). The patient
had him press on the hernia and immediately felt burning pain throughout the abdomen. Which of the
following is the nurse practitioners' NEXT action?
1. Abdominal CT scan
2. Complete blood count with differential
3. Abdominal ultrasound
4. Referral to the ED Correct Answer: 4. Referral to the ED
2. A young adult female who is 34 weeks pregnant presents with the complaint of urinary frequency
every 1 to 2 hours. The patient has no fever and denies back pain. A urine dipstick test is positive for
leukocyte esterase and nitrites. Microscopic analysis reveals 15-20 WBCs/hpf and a few bacteria. The
BEST choice for treatment of this patient's urinary tract infection would be:
1. trimethoprim-sulfamethoxazole (Bactrim), 160 mg/800 mg twice daily for 3 days.
2. cephalexin (Keflex), 500 mg four times daily for 7 days.
3. ciprofloxacin (Cipro), 500 mg twice daily for 7 days.
4. erythromycin, 250 mg three times daily for 5 days. Correct Answer: 2. cephalexin (Keflex), 500 mg
four times daily for 7 days.
3. An adult male presents with new-onset pain and tenderness in the low back and pain in the right
great toe after a weekend of golf. He denies experiencing numbness and tingling. Which of the following
would the nurse practitioner expect to find an investigation of this patient's low back pain?
1. Exacerbation of extremity symptoms with straight-leg raising
2. Loss of bowel and bladder function
3. Increased ankle jerk on evaluation of deep tendon reflexes
4. Increased lumbar lordosis Correct Answer: 1. Exacerbation of extremity symptoms with straight-leg
raising
4. A true statement about essential tremors is that they:
1. often begin with "pill-rolling" of one hand and may affect the legs, feet, and toes.
2. are often barely visible, rapid tremors.
3. are a characteristic of Parkinson's disease.
4. are slow tremors that are absent or minimal at rest and usually involve the hands. Correct Answer: 4.
are slow tremors that are absent or minimal at rest and usually involve the hands.
8. An elderly, obese female presents for evaluation of a painful rash, first noticed 2 weeks ago, located
under both breasts. The rash is visible as an area of confluent, beefy-red, excoriated lesions with smaller
satellite lesions extending beyond the borders of the main lesions. The KOH prep reveals pseudohyphae.
The nurse practitioner
would recommend a/an:
1. course of oral steroids and air drying of skin after showers.
2. topical antifungal and order a fasting blood glucose.
3. oral antibiotic and order a hemoglobin A1c.
4. high-potency topical corticosteroid and use of dry dressings. Correct Answer: 2. topical antifungal and
order a fasting blood glucose.
9. An older adult female complains of problems with urination. She reports that whenever she feels the
need to urinate, she is unable to "make it to the bathroom in time," and wets herself. Which type of
incontinence is MOST likely?
10. A young adult female presents with painful swelling of the right cheek anterior to the TMJ. The
diagnosis is sialadenitis. In addition to antibiotics, treatment for this patient should include:
1. hot soaks and lemon drops.
2. alternating heat and cold.
3. cold compresses and massage.
4. hot soaks and mucolytics. Correct Answer: 1. hot soaks and lemon drops.
11. Initial therapy for older adult patients with arthritic joints is:
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