AANP Emergency and Urgent Care

Question 1

A patient presents with sudden-onset severe headache described as 'the worst headache of my life.' What must be immediately ruled out?

Accepted Answer

Subarachnoid hemorrhage

Answer

A thunderclap headache (sudden, severe, worst of life) is subarachnoid hemorrhage until proven otherwise; immediate non-contrast CT head is required.

Question 2

A patient with known COPD presents with increased dyspnea, productive cough, and wheezing. Oxygen saturation is 88%. What is the appropriate oxygen target?

Accepted Answer

Maintain SpO2 at 88–92%

Answer

In COPD exacerbations, oxygen should be titrated to maintain SpO2 at 88–92% to relieve hypoxemia without suppressing the hypoxic respiratory drive and causing hypercapnia.

Question 3

A patient presents with sudden dyspnea, pleuritic chest pain, and hypoxia after a long flight. Which test is most appropriate to confirm the diagnosis?

Accepted Answer

CT pulmonary angiography (CTPA)

Answer

CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism, directly visualizing clots in the pulmonary vasculature.

Question 4

A patient presents with sudden-onset unilateral weakness, facial droop, and slurred speech that resolved in 30 minutes. This presentation is most consistent with:

Accepted Answer

Transient ischemic attack (TIA)

Answer

TIA presents with sudden-onset focal neurological deficits that resolve within 24 hours (typically minutes) and requires urgent evaluation for stroke prevention.

Question 5

Which ECG finding indicates ST-elevation myocardial infarction (STEMI) requiring emergent intervention?

Accepted Answer

New ST elevation ≥1 mm in two contiguous leads

Answer

STEMI is defined by new ST elevation ≥1 mm in two or more contiguous leads (or ≥2 mm in V1–V3), indicating transmural ischemia requiring emergent PCI or thrombolytics.

AANP - American Association of Nurse Practitioners Practice Test

AANP - American Association of Nurse Practitioners Practice Test

AANP Emergency and Urgent Care