AANP Review Questions & Answers 2023/24 (Verified Answers)
A 64-year-old with HTN and DM presents with productive cough, fever, body aches. What diagnosis is most likely?
- Acute bronchitis
- Chronic bronchitis
- Pneumonia
- Pertussis
Correct Answer:
- Pneumonia
1st clue: 64-year-old
2nd clue: multiple comorbidities
3rd clue: cough, fever
what was the stem of the question?
Indications for a chest xray with acute cough
Correct Answer:
abnormal vital signs (increased RR or HR, temp >38c, 100.4F rales, consolidation > or equal 75 years of age with cough***
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***Pneumonia in older patient: tachypnea, decreased O2 sat, OR change in
mental status or behavior
A 75 year old patient wo smokes and has COPD presents with a worsening cough, weight loss, fatigue, and an enlarged right supraclavicular node. Which finding is most indicative of a right lung tumor?
- worsening cough
- weight loss
- fatigue
- supraclavicular node
Correct Answer:
- supraclavicular node
most important stem clue because this lymph node drains the chest and breast. It's a BIG deal!
If the stem gives a unilateral finding, look for a unilateral diagnosis
What symptoms most commonly accompany acute bronchitis?
- Fever, runny nose
- Cough, fever
- Cough and URI symptoms
- Cough, URI, and headache
Correct Answer:
- Cough and URI symptoms
Remember that bronchitis is an inflammation of the bronchioles, bronchi, and trachea; usually follows an upper respiratory infection 2 / 4
Starts above the shoulders and drops down into chest.
A 35 year old patient with acute bronchitis has no underlying lung disease. He
asks, "How long before my cough goes aways?" The NP responds:
- <1 week
- about 1 week
- 1-3 weeks
- >3 weeks
Correct Answer:
- 1-3 weeks
The patient with bronchitis will have evidence of upper AND lower airway symptoms.COUGH, COUGH, CO UGH, usually worse at night!
What is the management of bronchitis?
Correct Answer:
Treat symptoms!Time is the only thing for bronchitis ABX usually prescribed, but usually not necessary
Differential Diagnosis for Acute Bronchitis
Correct Answer:
PND Asthma 3 / 4
PNA Pertussis TB
Supraclavicular nodes: associated with high rates of malignancy. What organs
are on the right vs left?
Correct Answer:
RT: Lungs, mediastinum, esophagus
LT: Abdominal malignancy: stomach GB liver pancreas ovaries prostate
Pneumonia Vaccine Who?Who else?When is it given again?
Correct Answer:
Who-Prevention: Pneumococcal polysaccharide vaccination (PPSV) given once
in a lifetime to immunocompetent adults > or equal 65 years Who else-Adults 19-64 with --chronic CV, lung, liver disease --smokers, DM, ETOH, or asplenic --chronic care facilities --immunocompromising conditions When again-one time 5 years after for CRF, nephrotic syndrome, asplenia, sickle cell, immunocompromising conditions
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