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AANP FNP certification Exam test for 2024
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Exams of Nursing
3 month old infant with down syndrome, due to milk intolerance, mom started on goats milk; now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would you order? - Answer :Iron, TIBC 3 months of synthroid, TSH increased, T4 normal, what do you do? - Answer :Increase Medication 3 ways to assess cognitive function in patient with signs/symptoms of memory loss - Answer :Mini mental exam 4 month old with strabismus, mom is worried...... - Answer :tell her it is normal. 4 month old wont keep anything down, what is the main thing you look at? - Answer :Growth chart 6 month old closed anterior fontanel. - Answer :XRAY 88/yr. old patient in for follow up secondary. She's been treated with Tylenol for Joint arthritis. Her SED rate was checked after 6 weeks of treatment and it was 28. Normal range is from something to 25. How would you treat the pt. - Answer :be changed to NSAID, SED rate is a sign of inflammation a pregnant female at slightly above symphysis pubic and Fundal height is 32cm (above the umbilical). What should be done - Answer :Ultrasound
A1C > 9 - Answer :If you are already on TWO oral drugs for diabetes and A1c is 9 or higher, start BASAL insulin. If you cannot tolerate metformin and your A1c is 9 or higher start BASAL insulin. ON EXAM Abnormal cells on PAP, what do you do next? - Answer :Refer for Colposcopy ACE/ARB contraindications - Answer :pregnancy Renal failure Renal Stenosis ACEI contraindicated - Answer :pregnancy Acne Rosacea - Answer :- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. Clindamycin. EXAM Acne Rosacea - Answer :Acne Rosacea- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. EXAM Acne Vulgaris - Answer :common acne. Retin-A, acne worsens 4-6 weeks if no improvement in 8-12 weeks increase dose or add erythromycin, benzoyl peroxide. actinic keratoses - Answer :Precursor to squamous cell carcinoma. "numerous dry round and pink to red lesions" with a rough and scaly texture. Does not heal. Slow growing in sun exposed areas. Diagnosis: BIOPSY Golden Standard. Treatment: Sm. (cryotherapy), Lrg. (5-FU cream)- which causes ur skin to ooze, crust, scab, redness EXAM Actinic Keratosis - Answer :Numerous round dry pink to red areas. Scaly red to yellow located in sun exposed area
- a pre squamous cell carcinoma occurs on sun-damaged skin
All diastolic murmurs are pathological. Murmurs Grades I-barely II-audible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM - Answer :III first time audible, IV first time thrill Allergic Conjunctivitis - Answer :"stringy; increased tearing" PO antihistamines. Type I sensitivity. Typically bilateral. Rhinitis and allergic shiner. allergic rhinitis - Answer :blue pale turbinate clear drainage. Tx inhaled corticosteroids Aphthous stomatitis - Answer :Cancer sores. Aphthous stomatitis: painful shallow ulcers heal 7-10 days. Magic mouthwash. Assessment on patient with ascites - Answer :Dullness Assessment on patient with ascites - Answer :Dullness to percussion Atopic Dermatitis (eczema) - Answer :Inherited. Extremely itchy. On flexural folds, neck, hands. Inc. IgE. "small vesicles that rupture leaving painful, bright-red, weepy lesions" they become lichenified from itching. First line: Topical steroids. Avoid hot water/soaps. PO antihistamines. EXAM AV nicking (Arterioles pressing on vein of the eye) - Answer :HTN retinopathy Basal cell cancer - Answer :Waxy, pearly, telangiectasia, ulcer center lesion
- most common type of skin cancer caused by UV exposure. Metastatic is rare Bipolar med - Answer :lithium- monitor TSH, toxicity bind to TH cause hypothyroidism. blood pressure - Answer :BP - ST 1 (140-159/ 90-99), if you know this you will get the rest!! Normal is <120/80. ELERGLY OVER 60 150/90 IS OK. ISH WILL INCREASE SYSTOLIC NOT DIASTOLIC. ON EXAM. BPH and urge incontinence - Answer :anticholinergics/oxybutynin, impamine/tricyclic/antidepressant
Anticholinergic- can't think or blink, can't see (Increase eye pressure) or pee, can't spit or shit, SADCCUB sedation, anorexia, dry mouth confusion, constipation, urinary retention, BPH BPH and urge incontinence - Answer :TX anticholinergics/oxybutynin, impamine/tricyclic antidepressant CAGE ACRONYM - Answer :Cut down Annoyed by criticism Guilty about drinking Eye opener drink Carotid bruit - Answer :abnormal flow of blood through the carotid artery Carotid bruit - Answer :abnormal flow of blood through the carotid artery due to atherosclerotic disease Cataracts - Answer :is on EXAM in elderly night vision issues. Opaque Causes of tachycardia - Answer :Fever Anemia Hypotension CCB - Answer :BLE edema- walk around Cellulitis - Answer :Deep dermis poor demarcated low legs. EXAM/ MULTIPLE QUESTIONS. DVT RISK, DM WITH CELLULITIS WATCH FOR OSTEOMYLITIS. chlamydia in pregnancy - Answer :Azithromycin 1 gm PO x1 or Amoxicillin 500 mg PO TID x7d. Test of cure 3 weeks after completion of treatment (PREGO). EXAM Chlamydia trachomatis - Answer :Doxycycline (+ ceftriaxone for gonorrhea coinfection)
pregnancy, smoking, theophylline Common causes of GERD - Answer :risk factors- alcohol, anticholinergic, CCB, chocolate peppermint, fatty, spicy, citrus foods, hormones, obesity, pregnancy, smoking, theophylline, exacerbated by CCB verapamil Conductive - Answer :Conductive: Lateralization to bad ear. Rinne- BC > AC. Rinne (1st mastoid, 2 front of ear, time each area). Weber: Tunning fork midline. CN 8 (acoustic). EXAM COPD - Answer :COPD- Gold 1- 2 - SABA or SAMA ON EXAM.BASCIALLY ANTICHOLINERGIC FIRST LINE FOR COPD ON EXAM Gold 1-2 that are poor controlled- LAMA or LABA. May use SABA for rescue. Gold 3-4 LAMA first line. If poor use LAMA plus LABA. Alternative is LABA + ICS. Gold 3- 4 - refer SABA- Albuterol, levoalbuterol (terol) LABA- Formeterol, salmeterol (Terol) SAMA- Atrovent Ipatropium (tropium) LAMA- Spiriva Tiotroium (tropium) COPD long term is OXYGEN Corneal abrasion - Answer :Corneal Abrasions- Round/Irregular. Was on EXAM. Cranial nerves responsible for extraocular eye movements - Answer :CN 3,4,
cushings - Answer :Central obesity, moon face, purple striae, hairy, hypertension, elevated plasma CORTISOL in AM. "INC BS, SODIUM" Dec K. You must draw cortisol levels in the morning. CVI - Answer :CVI- Impaired venous return. Achy legs relieved by elevation, edema after prolonged standing, night cramps, brownish discoloration, cold, ulcers. Etc. do support stockings. EXAM Dacrocystitis - Answer :Darcryotosis lacrimal sac, rub down towards mouth. If think secondary infection abx. EXAM how it presents. Definition of metabolic syndrome - Answer :cluster of conditions that increase risk of heart disease, stroke, diabetes. Definitive diagnosis of acute bacterial prostatitis - Answer :urinalysis and culture Depression med acute Anxiety/ panic med GAD med - Answer :depression SSRI panic benzo, Xanax, ativan GAD SSRI SNRI- Buspar, Effexor, Cymbalta- Taper OFF Diabetic Retinopathy - Answer :Diabetic Retinopathy-Cotton wool spots (moderate retinopathy), micro-aneurysms. ALSO RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR ORANGE RED diagnose trichomoniasis - Answer :wet prep Direct Coombs test - Answer :r/o bilirubin eating, painful lump noted on the jaw that comes and go. - Answer :sialolithiasis).
cigarette smoking age older than 35 years history of infertility use of assisted reproductive technology, such as in vitro fertilization (IVF) Fibromyalgia polymyalgia - Answer :Fibro- 11/18 points. Widespread pain for at least three months. EXAM. polymyalgia Tx prednisone 12 months. Must taper off. RISK for Temporal arteritis, DX BX, elevated ESR Fifth's Disease (Erythema Infectiosum) - Answer :B19: lytic infection, respiratory transmission Sx: flushed rash/fever in kids Px: fever, get better in a week Fingernail hematoma treatment? - Answer :drill hole and drain blood? for staph aureus infection (skin) with pus - Answer :MRSA- TX Bactrim or tetracyclines? Fructosamine test - Answer :checks sugar for past 2-4 weeks. Fundal Height - Answer :Fundal Height 12 weeks above symphysis pubis. EXAM TOPICS Fundus 16 weeks between symphysis pubis and umbilicus. Fundus at 20 weeks is at umbilicus. 2 cm more of less from # of wk gestation is normal if more or less order US. Fundal height 12 weeks - Answer :Fundal Height 12 weeks above symphysis pubis. EXAM
Fundus 16 weeks between symphysis pubis and umbilicus. Fundus at 20 weeks is at umbilicus. 2 cm more of less from # of wk gestation is normal if more or less order US Genital warts treatment - Answer :Cryotherapy OR Podophyllotoxin cream - OR Imiquimod (Aldara cream) GERD treatment - Answer :H2 is first line, give hs German Measles (Rubella) - Answer :Pink, papular rash (similar to measles but paler) first appears on face, then spreads. Distinguished from measles by presence of neck lymphadenopathy and absence of Koplik spots. Grade 3 cells on Pap, treatment? - Answer :LEEP excision grandiosity - Answer :Exaggerated belief in or claims about one's importance or identity. Bipolor headache after trauma - Answer :SDH heart murmur with holosystolic or pan systolic Heart mumur with mid systolic - Answer :MR - radiate axilla, 5th ICS MCL, apex, AS - radiate neck, 2ICS right sternal border MR ASSH
IBS (irritable bowel syndrome) - Answer :An intestinal disorder causing pain in the belly, gas, diarrhea, and constipation. due to Small intestinal bacterial overgrowth, or SIBO IBS (irritable bowel syndrome) - Answer :SS pain in the belly, gas, diarrhea, and constipation. Pencil like stool. Caused by: Small intestinal bacterial overgrowth, or SIBO TX fiber, avoid gas foods, antispasmodics, decrease life stress Impetigo - Answer :Impetigo-Gram positive. Itchy pink-red lesions, evolve into vesiculopustules that rupture. If bullous-large blisters. Severe- Keflex, dicloxacillin. PCN Allergic-Azithro, clinda. If NO BULLAE- Bactroban. EXAM Increased risk of ectopic pregnancy - Answer :Salpingitis, or history of abortion, PID, intraocular pressure (IOP) - Answer :Fluid pressure inside the eye; measured with tonometry intussusception - Answer :telescoping obstruction of the intestines, cuts off blood supply, fatal, sudden loud crying, comes/goes, vomiting, blood/mucus mixed with stool, SAUSAGE LIKE MASS intussusception - Answer :telescoping obstruction of the intestines, cuts off blood supply, fatal, sudden loud crying, comes/goes, vomiting, blood/mucus mixed with stool, SAUSAGE LIKE MASS CURRENT JELLY STOOL Isolated Systolic HTN - Answer :CCB JVD caused by - Answer :-tension pneumothorax,
- Rt. sided heart failure,
- cardiac tamponade,
- traumatic axphysia from Increase in portal pressure(LIVER) in venous side or cor pulmonale Kava Kava - Answer :anxiety and insomnia, don't mix w sedating benzos. Kawasaki disease - Answer :- acute high fever, enlarged lymph. BRIGHT RED RASH, conjunctivitis, dry cracked lips, strawberry tongue, Swollen hands, feet, AFTER the fever resides the rash PEELS on hands/feet. Treated with high dose aspirin and gamma globulin. This is TOXIC and VASCULAR, think blood clots, heart problems etc. Treat: high dose aspirin. EXAM Know the difference between Peripheral Arterial Disease and Chronic Venous Insufficiency or PVD. There was question about PAD. - Answer :PAD: Absence of pulse, decrease blow flowing down, PAIN, Dx doppler or ABI<0.9, TX exercise by walking or antiplatelet, PVD: Volume, edema, discoloration, decrease blood going up, Koplick spots - Answer :Measles (rubeola). Grains of salt lesions inside mouth in Measles Koplick spots - Answer :Measles (rubeola). Grains of salt lesions inside mouth in Measles
NO TZD ACTOS (Pioglitazone) GIVE Metformin, ACE or ARB- kidney protective, BB- causes hypoglycemia, Metformin - Answer :Metformin - monitor BUN, Creatinine. contraindicated renal and liver disease ARF creatinine up and GFR down. affects liver enzymes, weight loss, avoid in alcohol drinkers, lactic acidosis, diarrhea flatulence CT: hold 24 hr before and 48hr after migraine headache - Answer :-paroxysmal (sudden, periodic) attacks of mostly unilateral headache, often accompanied by disordered vision, nausea, or vomiting, lasting hours or days and caused by dilation of arteries. 4 - 12 hours, abortive triptans prophylaxis propranolol, TCA amitriptyline, anticonvulsants topiramate Mitral Regurg - Answer :(Holo/pansystolic)- radiates to axilla. Think Mitral area 5th ics MCL. Aortic Stenosis (mid systolic ejection) radiates to neck. Think 2ics rsb. Moderate acne treatment - Answer :Without inflammation: Topical retinoid
Moderate inflammation: Topical Retinoid or benzoyl peroxide or Azaleic acic ( very expensive and hard to get covered) PLUS ADD Oral antibiotics: doxycycline or tetracycline or minocycline- (tetracyclines has been proven most affective for inflammatory acne) Minocycline- long term use has been linked with pseudotumor cerebri Oral contraceptives for hormone related Spironolactone Molluscum contagiosum treatment - Answer :Currettage, liquid nitrogen Mono - Answer :test heterophile antibody test. ON EXAM Mono, return to play and Dx - Answer :4-6 weeks when spleenolmegaly resolves Mono spot/ Heterophile Most common cause of death in children - Answer :motor vehicle MR. ASS - Answer :(Systolic Murmur) Only systolic murmurs will radiate to a location on the exam. Murmur Grade III - VI - Answer :Loud murmur easily heard MVP - Answer :MVP- S2 click, followed by systolic murmur. Asymptomatic. MVP with palpitations is treated with BB. LATE SYSTOLIC.
Osteoporosis - Answer :OSTEOPOROSIS = WEIGHT BEARING- walking, lifting weights etc. bones are forced against gravity. EXAM Osteoporosis Risk Factors (ACCESS) - Answer :A-lcohol Use C-orticosteroid Use C-alcium low E-strogen low S-moking S-edentary lifestyle/s ACCESS leads to OSTEOPOROSIS Osteoporosis treatment - Answer :TX BIOPHOSPHATES alendronate, Fosamax, CALCIUM 500 mg, vitamin D food and supplementation, testosterone, WT BEARING EXERCISE CAUCASIAN and ASIAN affected most RISK PPI, STATIN, STEROIDS, THYROID, Osteopenia- increase calcium dark green vegetables, salmon, sardines, soy and OJ Hormone (estrogen) replacement therapy (HRT) slows bone loss Natural progesterone cream prompts new bone growth BONE DENSITY >2.
Osteoporosis treatment - Answer :TX first line is bisphosphonates alendronate, Fosamax, calcium500 mg, vitamin d thru food and supplementation, testosterone, wt bearing exercise Osteopenia- increase calcium dark green vegetables, salmon, sardines, soy and OJ Hormone (estrogen) replacement therapy (HRT) slows bone loss Natural progesterone cream prompts new bone growth Statins increase bone mineral density PAD/ PVD - Answer :PAD/ PVD (same)- Nocturnal pain relieved by lowering legs, poor pulses, dependent rubor, intermittent claudication, atrophy, shiny, hairless, cold feet. Initial do a pulse check, ABI 0.9 or less is PAD. Ateriography is the most DEFINITIVE test. Try to develop collateral circulation. Otherwise- Trental, Pletal. EXAM Pancreatitis - Answer :diagnosed with amylase / lipase draw. Amylase beings 2-12 h. Lipase 4-8 hours. Lipase however is MORE specific and sensitive to alcoholic pancreatitis. ACUTE: Grey Turner/ Cullen sign. Abd pain that rates to midback "boring" epigastric pain. Fever, n/v. EXAM TOPICS papilledema - Answer :optic disc swollen w/ blurred edges due to increased ICP EXAM Papilledema - Answer :Swollen, optic disc, increase cup to disc ratio, HA, ICP, HTN, Parathyroid - Answer :For parathyroid- dx blood test. You will have elevated calcium because your parathyroid is releasing too much from bones and this will just cause it to float around and not help ur bones. TX: BIPHOSPHANATES FOR SECONDARY HYPERPARATHY. EXAM
