ANCC PRACTICE QUESTIONS AND ANSWERS
In the early stages of iron deficient anemias, blood studies show:
(a) macrocytic normochromic
(b) microcytic hypochromic
(c) normochromic normocytic
(d) pancytopenic hypocytic - Answers -(a) normochromic normocytic
A 14-year-old, male patient has some general concerns about eczema, as his twin
brother was recently diagnosed with this condition. The patient reports urticaria and a
rash on his posterior knees bilaterally. The three factors that put the patient at risk for
eczema are a family history of eczema, a personal history of allergic rhinitis, and a
history of:
(a) asthma
(b) bee allergy
(c) otitis media
(d) psoriasis - Answers -(a) asthma
A patient has hyperactive reflexes of the lower extremities. The adult-gerontology
primary care nurse practitioner assesses for ankle clonus by:
(a) firmly applying a low-pitched tuning fork to the lateral malleolus.
(b) flexing the leg at the knee, rotating it externally, and striking the Achilles tendon with
the percussion hammer.
(c) sharply dorsiflexing the foot and maintaining this position while supporting the knee.
(d) stroking the lateral aspect of the sole from the heel to the ball of the foot with the
sharp end of the percussion hammer. - Answers -(c) sharply dorsiflexing the foot and
maintaining this position while supporting the knee.
A 70-year-old, female patient is having her yearly evaluation. The adult-gerontology
primary care nurse practitioner gives which physical examination finding the highest
priority for immediate treatment?
(a) Atrophy of vaginal rugae.
(b) Cystocele present.
(c) Palpable ovary.
(d) Pessary in place. - Answers -(c) Palpable ovary.
The adult-gerontology primary care nurse practitioner reminds a 16-year-old, male
patient who just received his driver's license to wear a seat belt at all times when in a
car. The patient replies that he does not need to wear a seat belt, because nothing will
,happen to him if he is involved in an automobile collision. According to the health belief
model, what chief component does the patient lack?
(a) Enabling factors.
(b) Motivation.
(c) Perceived role conflict.
(d) Perceived severity. - Answers -(d) Perceived severity.
The adult-gerontology primary care nurse practitioner treats several patients for
biological exposure. In the patients' records, the nurse practitioner documents which
epidemiological factors for each exposure?
(a) Comorbidities and length of exposure.
(b) Location and event intensity.
(c) Mode of transmission and incubation.
(d) Premorbid conditions and surveillance rates. - Answers -(c) Mode of transmission
and incubation.
When disseminating research findings in a peer-reviewed journal, the adult-gerontology
primary care nurse practitioner:
(a) concludes that the study proves the hypothesis.
(b) excludes the discussion section, because the conclusion contains this information.
(c) recommends incorporating the results directly into clinical practice.
(d) uses the methodology section to support the validity of the study. - Answers -(d)
uses the methodology section to support the validity of the study.
Before placing a patient with onychomycosis on a pulsed dose of itraconazole
(Sporanox), which laboratory values does the adult-gerontology primary care nurse
practitioner obtain?
(a) Liver function studies.
(b) Platelet count.
(c) Renal function studies.
(d) White blood cell count. - Answers -(a) Liver function studies.
A 30-year-old, female patient has a two-week history of nausea, vomiting, decreased
weight, abdominal pain, and a long-term history of multiple sexual partners. The
patient's physical examination reveals abdominal tenderness with icteric sclerae and
skin. Which laboratory test confirms active hepatitis B?
,(a) Antibody.
(b) Enzyme-linked immunosorbent assay.
(c) Immune globulin G.
(d) Surface antigen. - Answers -(d) Surface antigen.
For two to three months, a 78-year-old patient has not been taking levothyroxine
(Synthroid) as prescribed. The patient now has symptoms of increasing constipation,
lethargy, and weakness. The adult-gerontology primary care nurse practitioner
anticipates that laboratory tests will show that the patient's:
(a) T4 level decreased, and TSH level increased.
(b) T4 level increased, and TSH level decreased.
(c) T4 level increased, and TSH level is unchanged.
(d) T4 level is unchanged, and TSH level decreased. - Answers -(a) T4 level decreased,
and TSH level increased.
A 68-year-old patient has sustained an unintended weight loss of 15 lb (6.8 kg) over the
last two months but reports feeling well. The patient's problems include depression,
tobacco abuse, obesity, and dyslipidemia. His or her medications are sertralizine
(Zoloft), simvastatin (Zocor), and famotidine (Pepcid). The adult-gerontology primary
care nurse practitioner performs which THREE actions?
(a) Adds a probiotic.
(b) Conducts a depression screening.
(c) Decreases the dosage of the statin medication.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone. - Answers -(b) Conducts a depression
screening.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.
Preparing to implement an incontinence reduction program at a nursing home, the
adult-gerontology primary care nurse practitioner reviews several studies. Place the
, studies in sequential order of the strength of evidence for this population from strongest
to weakest.
(a) A case report of an experimental incontinence reduction program in older adults.
(b) A consensus statement from the urologic association regarding the use of scheduled
toileting.
(c) A systematic review of nonrandomized trials concerning the use of vaginal estrogen.
- Answers -Strongest evidence: (c) a systematic review
...then: (b) a consensus statement
Weakest evidence: (a) a case report
What factors does the adult-gerontology primary care nurse practitioner need to
consider when discussing advanced care planning with a patient?
(a) Autonomy and patient safety are rarely competitive considerations.
(b) Decisions regarding a health care representative are a family group decision.
(c) Family members are not integral components in care planning.
(d) Trust and rapport with patients are key to patient satisfaction in decisions for care. -
Answers -(d) Trust and rapport with patients are key to patient satisfaction in decisions
for care.
The adult-gerontology primary care nurse practitioner working in an urban community
health center recognizes that asthma-related health issues commonly result in higher
morbidity and mortality for persons with:
(a) alcohol dependency.
(b) lower socioeconomic status.
(c) persistent social isolation.
(d) recent immigrant status. - Answers -(b) lower socioeconomic status.
During an annual health visit, a 15-year-old female patient is found to have grown 5 in
(12.7 cm) over the past year. She has not reached menarche. Her mother is concerned
because the patient's sister reached menarche at age 11 and the mother reached
menarche at age 12. Examination reveals that the patient's breasts are enlarged, with
the areolae forming a mound above the general contour of each breast, and that the left
breast is larger than the right. Axillary hair is absent and the pubic hair is dark, coarse,
In the early stages of iron deficient anemias, blood studies show:
(a) macrocytic normochromic
(b) microcytic hypochromic
(c) normochromic normocytic
(d) pancytopenic hypocytic - Answers -(a) normochromic normocytic
A 14-year-old, male patient has some general concerns about eczema, as his twin
brother was recently diagnosed with this condition. The patient reports urticaria and a
rash on his posterior knees bilaterally. The three factors that put the patient at risk for
eczema are a family history of eczema, a personal history of allergic rhinitis, and a
history of:
(a) asthma
(b) bee allergy
(c) otitis media
(d) psoriasis - Answers -(a) asthma
A patient has hyperactive reflexes of the lower extremities. The adult-gerontology
primary care nurse practitioner assesses for ankle clonus by:
(a) firmly applying a low-pitched tuning fork to the lateral malleolus.
(b) flexing the leg at the knee, rotating it externally, and striking the Achilles tendon with
the percussion hammer.
(c) sharply dorsiflexing the foot and maintaining this position while supporting the knee.
(d) stroking the lateral aspect of the sole from the heel to the ball of the foot with the
sharp end of the percussion hammer. - Answers -(c) sharply dorsiflexing the foot and
maintaining this position while supporting the knee.
A 70-year-old, female patient is having her yearly evaluation. The adult-gerontology
primary care nurse practitioner gives which physical examination finding the highest
priority for immediate treatment?
(a) Atrophy of vaginal rugae.
(b) Cystocele present.
(c) Palpable ovary.
(d) Pessary in place. - Answers -(c) Palpable ovary.
The adult-gerontology primary care nurse practitioner reminds a 16-year-old, male
patient who just received his driver's license to wear a seat belt at all times when in a
car. The patient replies that he does not need to wear a seat belt, because nothing will
,happen to him if he is involved in an automobile collision. According to the health belief
model, what chief component does the patient lack?
(a) Enabling factors.
(b) Motivation.
(c) Perceived role conflict.
(d) Perceived severity. - Answers -(d) Perceived severity.
The adult-gerontology primary care nurse practitioner treats several patients for
biological exposure. In the patients' records, the nurse practitioner documents which
epidemiological factors for each exposure?
(a) Comorbidities and length of exposure.
(b) Location and event intensity.
(c) Mode of transmission and incubation.
(d) Premorbid conditions and surveillance rates. - Answers -(c) Mode of transmission
and incubation.
When disseminating research findings in a peer-reviewed journal, the adult-gerontology
primary care nurse practitioner:
(a) concludes that the study proves the hypothesis.
(b) excludes the discussion section, because the conclusion contains this information.
(c) recommends incorporating the results directly into clinical practice.
(d) uses the methodology section to support the validity of the study. - Answers -(d)
uses the methodology section to support the validity of the study.
Before placing a patient with onychomycosis on a pulsed dose of itraconazole
(Sporanox), which laboratory values does the adult-gerontology primary care nurse
practitioner obtain?
(a) Liver function studies.
(b) Platelet count.
(c) Renal function studies.
(d) White blood cell count. - Answers -(a) Liver function studies.
A 30-year-old, female patient has a two-week history of nausea, vomiting, decreased
weight, abdominal pain, and a long-term history of multiple sexual partners. The
patient's physical examination reveals abdominal tenderness with icteric sclerae and
skin. Which laboratory test confirms active hepatitis B?
,(a) Antibody.
(b) Enzyme-linked immunosorbent assay.
(c) Immune globulin G.
(d) Surface antigen. - Answers -(d) Surface antigen.
For two to three months, a 78-year-old patient has not been taking levothyroxine
(Synthroid) as prescribed. The patient now has symptoms of increasing constipation,
lethargy, and weakness. The adult-gerontology primary care nurse practitioner
anticipates that laboratory tests will show that the patient's:
(a) T4 level decreased, and TSH level increased.
(b) T4 level increased, and TSH level decreased.
(c) T4 level increased, and TSH level is unchanged.
(d) T4 level is unchanged, and TSH level decreased. - Answers -(a) T4 level decreased,
and TSH level increased.
A 68-year-old patient has sustained an unintended weight loss of 15 lb (6.8 kg) over the
last two months but reports feeling well. The patient's problems include depression,
tobacco abuse, obesity, and dyslipidemia. His or her medications are sertralizine
(Zoloft), simvastatin (Zocor), and famotidine (Pepcid). The adult-gerontology primary
care nurse practitioner performs which THREE actions?
(a) Adds a probiotic.
(b) Conducts a depression screening.
(c) Decreases the dosage of the statin medication.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone. - Answers -(b) Conducts a depression
screening.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.
Preparing to implement an incontinence reduction program at a nursing home, the
adult-gerontology primary care nurse practitioner reviews several studies. Place the
, studies in sequential order of the strength of evidence for this population from strongest
to weakest.
(a) A case report of an experimental incontinence reduction program in older adults.
(b) A consensus statement from the urologic association regarding the use of scheduled
toileting.
(c) A systematic review of nonrandomized trials concerning the use of vaginal estrogen.
- Answers -Strongest evidence: (c) a systematic review
...then: (b) a consensus statement
Weakest evidence: (a) a case report
What factors does the adult-gerontology primary care nurse practitioner need to
consider when discussing advanced care planning with a patient?
(a) Autonomy and patient safety are rarely competitive considerations.
(b) Decisions regarding a health care representative are a family group decision.
(c) Family members are not integral components in care planning.
(d) Trust and rapport with patients are key to patient satisfaction in decisions for care. -
Answers -(d) Trust and rapport with patients are key to patient satisfaction in decisions
for care.
The adult-gerontology primary care nurse practitioner working in an urban community
health center recognizes that asthma-related health issues commonly result in higher
morbidity and mortality for persons with:
(a) alcohol dependency.
(b) lower socioeconomic status.
(c) persistent social isolation.
(d) recent immigrant status. - Answers -(b) lower socioeconomic status.
During an annual health visit, a 15-year-old female patient is found to have grown 5 in
(12.7 cm) over the past year. She has not reached menarche. Her mother is concerned
because the patient's sister reached menarche at age 11 and the mother reached
menarche at age 12. Examination reveals that the patient's breasts are enlarged, with
the areolae forming a mound above the general contour of each breast, and that the left
breast is larger than the right. Axillary hair is absent and the pubic hair is dark, coarse,
