AANP FNP certification Exam Questions with answers, 100% proven pass rate, Graded A+

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AANP FNP certification Exam Questions with answers, 100% proven pass rate, Graded A+ 3 month old infant with down syndrome, due to milk intolerance, mom started on goats milk; now has pale conjunct... iva but otherwise healthy. Low HCT. What additional test would you order? - ✔✔Iron, TIBC 3 months of synthroid, TSH increased, T4 normal, what do you do? - ✔✔Increase Medication 3 ways to assess cognitive function in patient with signs/symptoms of memory loss - ✔✔Mini mental exam 4 month old with strabismus, mom is worried...... - ✔✔tell her it is normal. 4 month old wont keep anything down, what is the main thing you look at? - ✔✔Growth chart 6 month old closed anterior fontanel. - ✔✔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. - ✔✔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 - ✔✔Ultrasound A1C > 9 - ✔✔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? - ✔✔Refer for Colposcopy ACE/ARB contraindications - ✔✔pregnancy Renal failure Renal Stenosis ACEI contraindicated - ✔✔pregnancy Acne Rosacea - ✔✔- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. Clindamycin. EXAM Acne Rosacea - ✔✔Acne Rosacea- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. EXAM Acne Vulgaris - ✔✔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 - ✔✔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 - ✔✔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 biopsy cryo or 5fu cream Actinic Keratosis - ✔✔Scaly red to yellow located in sun exposed area -a precancerous skin growth that occurs on sun-damaged skin Acute Angle Closure Glaucoma - ✔✔acute/severe halos, cupping optic nerve, cloudy cornea, mid-dilated oval pupil. ER STAT. EXAM Acute Bacterial Pneumonia- CXR - ✔✔middle lobe. ON EXAM Acute Closed Angle Glaucoma Vs Open Angle - ✔✔Acute: Sudden pain, halos, cupping, dilated, cloudy , IOP, HA, refer ED Open (primary) : CN 2, gradual loss peripheral vision first Acyclovir (cheapest) - ✔✔200mg 5 x day Addison's - ✔✔Addison's- deficient in cortisol (think low sodium, blood sugar, but Increase K. You must give cortisol. (Diagnosis Plasma Cortisol <5 mcg/dl @ 0800.) EXAM ADHD - ✔✔A behavioral problem characterized by short attention span, restless movement, and impaired learning capacity. All diastolic murmurs are pathological. Grades Murmurs - ✔✔I-barely II-audible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM 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 - ✔✔III first time audible, IV first time thrill Allergic Conjunctivitis - ✔✔"stringy; increased tearing" PO antihistamines. Type I sensitivity. Typically bilateral. Rhinitis and allergic shiner. allergic rhinitis - ✔✔blue pale turbinate clear drainage. Tx inhaled corticosteroids Aphthous stomatitis - ✔✔Cancer sores. Aphthous stomatitis: painful shallow ulcers heal 7-10 days. Magic mouthwash. Assessment on patient with ascites - ✔✔Dullness Assessment on patient with ascites - ✔✔Dullness to percussion Atopic Dermatitis (eczema) - ✔✔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) - ✔✔HTN retinopathy Basal cell cancer - ✔✔Waxy, pearly, telangiectasia, ulcer center lesion -most common type of skin cancer caused by UV exposure. Metastatic is rare Bipolar med - ✔✔lithium- monitor TSH, toxicity bind to TH cause hypothyroidism. blood pressure - ✔✔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 - ✔✔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 - ✔✔TX anticholinergics/oxybutynin, impamine/tricyclic antidepressant CAGE ACRONYM - ✔✔Cut down Annoyed by criticism Guilty about drinking Eye opener drink Carotid bruit - ✔✔abnormal flow of blood through the carotid artery Carotid bruit - ✔✔abnormal flow of blood through the carotid artery due to atherosclerotic disease Cataracts - ✔✔is on EXAM in elderly night vision issues. Opaque Causes of tachycardia - ✔✔Fever Anemia Hypotension CCB - ✔✔BLE edema- walk around Cellulitis - ✔✔Deep dermis poor demarcated low legs. EXAM/ MULTIPLE QUESTIONS. DVT RISK, DM WITH CELLULITIS WATCH FOR OSTEOMYLITIS. chlamydia in pregnancy - ✔✔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 - ✔✔Doxycycline (+ ceftriaxone for gonorrhea coinfection) cholesteatoma - ✔✔chronic sinusitis or OM. cauliflower, foul-smell, hearing loss. erodes bones in face affects facial CN 7. Benign- risk hearing loss refer SURGERY Chronic Bronchitis Treatment - ✔✔Smoking cessation Pulmonary rehabilitation Pharmacologic therapy Supplemental oxygen CN IX Glossopharyngeal - ✔✔- Shoulder shrug/ ROMBERG test EXAM CN V Trigeminal - ✔✔Herpes. CORNEAL ABRASION. EXAM CN VII Facial - ✔✔BELLS EXAM CN VIII Vestibulocochlear - ✔✔ears 8 EXAM Coarctation of Aorta - ✔✔COA: bounding radial and weak femoral pulse increase blood pressure in arms, and lower pressure in lower legs. -congenital cardiac condition characterized by a narrowing of the aorta - Common causes of GERD - ✔✔risk factors- alcohol, anticholinergic, CCB, BB chocolate peppermint, fatty, spicy, citrus foods, hormones, obesity, pregnancy, smoking, theophylline Common causes of GERD - ✔✔risk factors- alcohol, anticholinergic, CCB, chocolate peppermint, fatty, spicy, citrus foods, hormones, obesity, pregnancy, smoking, theophylline, exacerbated by CCB verapamil Conductive - ✔✔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 - ✔✔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 - ✔✔Corneal Abrasions- Round/Irregular. Was on EXAM. Cranial nerves responsible for extraocular eye movements - ✔✔CN 3,4,6 cushings - ✔✔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 - ✔✔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 - ✔✔Darcryotosis lacrimal sac, rub down towards mouth. If think secondary infection abx. EXAM how it presents. Definition of metabolic syndrome - ✔✔cluster of conditions that increase risk of heart disease, stroke, diabetes. Definitive diagnosis of acute bacterial prostatitis - ✔✔urinalysis and culture Depression med acute Anxiety/ panic med GAD med - ✔✔depression SSRI panic benzo, Xanax, ativan GAD SSRI SNRI- Buspar, Effexor, Cymbalta- Taper OFF Diabetic Retinopathy - ✔✔Diabetic Retinopathy-Cotton wool spots (moderate retinopathy), micro-aneurysms. ALSO RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR ORANGE RED diagnose trichomoniasis - ✔✔wet prep Direct Coombs test - ✔✔r/o bilirubin eating, painful lump noted on the jaw that comes and go. - ✔✔sialolithiasis). Elderly presents with atrophic vaginitis, small uterus, palpable 4x5 ovary, what do you do next? - ✔✔Pelvic US Emphysema - ✔✔Emphysema Lungs- Percussion-HYPERENNOSANCE tactile frem + egophony- dec. CXR- flattened diaphragms with hyperinflation. Inc. AP diameter, accessory muscles, pursed-lip breathing, weight loss. ON EXAM Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located? - ✔✔Anterior septum Erysipelas - ✔✔Group A strep, painful, Upper dermis, clear demarcated, cheeks, shins. TREATMENT- Dicloxacillin QID x10d. Cephalexin, Clinda. PCN ALLERGY? Do Azithro x5d. MRSA TREATMENT: Bactrim, doxy, mino, clinda. If sulfa allergy do not use Bactrim. Erythema migrans - ✔✔Erythema Migraines- (stage 1 Lyme) Target bulls-eye, usually appears in 7-14 days POST bitten tick. Rash is hot to touch with rough texture, flu like symptoms. DX: B. Burgdorferi via ELISA, confirm with western blot. Increased ESR. TREATMENT: Less than 7 Amoxicillin or cefuroxime axetil. Older than 7 Doxycycline. EXAM Etopic Pregnancy: Risk Factors - ✔✔Previous ectopic pregnancy Prior fallopian tube surgery Previous pelvic or abdominal surgery Certain sexually transmitted infections (STIs) Pelvic inflammatory disease Endometriosis cigarette smoking age older than 35 years history of infertility use of assisted reproductive technology, such as in vitro fertilization (IVF) Fibromyalgia polymyalgia - ✔✔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) - ✔✔B19: lytic infection, respiratory transmission Sx: flushed rash/fever in kids Px: fever, get better in a week Fingernail hematoma treatment? - ✔✔drill hole and drain blood? for staph aureus infection (skin) with pus - ✔✔MRSA- TX Bactrim or tetracyclines? Fructosamine test - ✔✔checks sugar for past 2-4 weeks. Fundal Height - ✔✔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 - ✔✔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 - ✔✔Cryotherapy OR Podophyllotoxin cream - OR Imiquimod (Aldara cream) GERD treatment - ✔✔H2 is first line, give hs German Measles (Rubella) - ✔✔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? - ✔✔LEEP excision grandiosity - ✔✔Exaggerated belief in or claims about one's importance or identity. Bipolor headache after trauma - ✔✔SDH heart murmur with holosystolic or pan systolic Heart mumur with mid systolic - ✔✔MR - radiate axilla, 5th ICS MCL, apex, AS - radiate neck, 2ICS right sternal border MR ASSH Herpetic keratitis - ✔✔ocular herpes - blurr vision, inflammation of eye; gritty feeling, conjunctivitis, sharp pain, and photophobia- AVOID SUN REFER OPTHO Tx acyclovir HIV pt. with antiviral and CD4 count still less than 200. What should NP tell the pt. - ✔✔tell the pt. that he is qualified to be diagnosed with AIDS according to CDC hordeolum Vs chalazion blepharitis - ✔✔hordeolum: painful swollen red warm abscess TREAT hot compress erythromycin, dicloxacillin. chalazion does not hurt Blepharitis always unilateral, Tx baby shampoo warm compress horizontal nystagmus that stops when eye is close to midline in a college student - ✔✔Ménière's disease ? HTN Retinopathy - ✔✔Hypertensive Retinopathy- Copper/silver wire arterioles. AV nicking(mild retinopathy). Retinal Hemorrhages. EXAM hyperparathyroidism - ✔✔high calcium hyperthyroid - ✔✔Hyperthyroid- Low TSH, high "FREE" T4/T3. ALWAYS DO FREEs. Graves disease-autoimmune. Lid lag, exophthalmos, everything is hyper (body wise). Treatment: PTU/Tapazole. PTU PREFER IN PREGNANCY RAIU-no w/ prego. Destroys thyroid, lifelong treatment for hypo then. [Show More]

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