AANP FNP Certification Study Guide Exam Questions (238 Terms), Exams of Nursing

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AANP FNP Certification Study Guide

Exam Questions (238 Terms) with

Definitive Solutions 2023-2024.

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

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 3-month-old infant with down syndrome, due to milk intolerance, mom started on goat’s 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 won’t keep anything down, what is the main thing you look at? -

Answer: Growth chart

6-month-old closed anterior fontanel. - Answer: XRAY

Abnormal cells on PAP, what do you do next? - Answer: Refer for Colposcopy

CAGE ACRONYM - Answer: Cut down

Annoyed by criticism Guilty about drinking Eye opener drink

Causes of tachycardia - Answer: Fever

Anemia Hypotension

Cranial nerves responsible for extraocular eye movements - Answer: CN 3,4,

Definition of metabolic syndrome - Answer: cluster of conditions that increase

risk of heart disease, stroke, diabetes.

diagnose trichomoniasis - Answer: wet prep

Elderly presents with atrophic vaginitis, small uterus, palpable 4x5 ovary, what do

you do next? - Answer: Pelvic US

Epistaxis is most common in the area of the nose known as kiesselbachs triangle,

where is this located? - Answer: Anterior septum

Definitive diagnosis of acute bacterial prostatitis - Answer: urinalysis and culture

GERD treatment - Answer: H2 is first line, give hs

Grade 3 cells on Pap, treatment? - Answer: LEEP

excision

Fingernail hematoma treatment? - Answer: drill hole and drain blood?

Increased risk of ectopic pregnancy - Answer: Salpingitis, or history of abortion,

PID,

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

Legg-Calve-Perthes Disease - Answer: Avascular necrosis of the proximal femoral

head

Lipid level of 1500, increased risk for? - Answer: Pancreatitis

Low HGB, Low HCT, High MCV indicates what? - Answer: Macrocytic anemia, B

Def

Man with BPH, prostate feels on digital exam? - Answer: Enlarged, symmetrical,

smooth

Man with HTN, CAD, present femoral pulses but absent pedal - Answer: Arterial

Insufficiency McMurray's Sign

(+) palpable or audible click while extending with varus stress - Answer:

Meniscus tears

Lachman's Test - Answer: pivot shift test (ACL tear)

Newborn with foot turned in, what do you do? - Answer: refer to orthopedist

Osgood-Schlatter disease - Answer: Knee pain.

inflammation or irritation of the tibia at its point of attachment with the patellar tendon Patient forgot to start Thanksgiving dinner and husband states she has trouble remembering tasks and trouble with organization. What is this indicative of? -

Answer: Alzheimer's

Pt has Barretts Esophagus, insurance no longer covers GI who was treating condition. Pt at FNP office wanting refill prescriptions. What do you do? -

Answer: Refer to oncologist

Pt presents with rash on shoulder, erythematous maculopapular rash with center

clearing and scaling? - Answer: Tinea Corporis

Pt presents with "bag of worms:, indicates? - Answer: Varicocele

Pt with atopic dermatitis, look for what other diseases? - Answer: Asthma

Pt with bleeding after menopause - Answer: endometrial biopsy, need to screen

for cancer

Pt with hx of PID, increased rick for? - Answer: Infertility

Pt with HIV took high potency anti viral treatments and CD4 is >400, what does

this indicate? - Answer: This is good. Want higher than 350

Pt with hx of htn and stroke, now having memory loss. What does this indicate? -

Answer: Vascular dementia

Pregnant teacher with exposure to 5ths disease (SLAP CHEEK), what risk is there

to the fetus? - Answer: slap cheek, PVB19, rash hands / feet Fetal death and

birth defects

Quick assessment of patients fall risk? Timed Get up and Go - Answer: Timed Get

up and Go

Red beefy tongue? - Answer: pernicious anemia

Rotator cuff injury presentation - Answer: disturbs sleep, arm weakness, dull

ache

Shingles near eye - Answer: immediate referral to ophthalmology

Signs and symptoms of Roseola (6ths disease)? - Answer: Viral infection

Can result in a maculopapular rash, but up to 70% of cases proceed without the rash stage

-Usually accompanied by a high fever (41°C or 105°F) that comes on quickly and lasts up to 3 days followed by rash -Seizures may occur during this period. -On the fourth day, the fever disappears and the rash appears, first on chest and trunk, then less prominently on the face and limbs. -High fever, pink flat or raised rash

Treatment for chronic alcoholism: - Answer: 12 step program

Treatment for Gonorrhea? - Answer: Rocephin 250mg IMx1 plus

Azithromycin 1 gm orally x1 to cover chlamydia. , or doxy 100 mg BID x7d. Green colored vaginal discharge, friable cervix. EXAM Report to health department Young female want birth control, forgets to take pills, does not want to get

pregnant for at least 5 years: - Answer: IUD

Basal cell cancer - Answer: Waxy, pearly, telangiectasia, ulcer center lesion

-most common type of skin cancer caused by UV exposure. Metastatic is rare

Actinic Keratosis - Answer: Scaly red to yellow located in sun exposed area

-a precancerous skin growth that occurs on sun-damaged skin

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 biopsy cryo or 5fu cream

subungual hematoma tx - Answer: Make a hole and drain the blood

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 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

Coarctation of Aorta - Answer: 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

Murmur Grade III - VI - Answer: Loud murmur easily heard

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 pt. with gradual onset of fever, hemorrhages on nail beds, painful raised red

nodules, rash on palms - Answer: endocarditis , painful red spots on fingers

olser's nodes, janeway legions rash on palms and soles.

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,

Chronic Bronchitis Treatment - Answer: Smoking cessation

Pulmonary rehabilitation Pharmacologic therapy Supplemental oxygen

TB... PPD is positive if area of induration is: - Answer: >5 mm in an

immunocompromised patient or close contact

10 mm in immigrant, health care workers, drug user 15 mm in a patient who lives in an area where TB is very rare. what condition would make you order Lateral X-ray of the neck. Options include:

Drooling, Unable to do ROM of the neck / stiff neck. - Answer: Croup/Epiglottitis

AV nicking (Arterioles pressing on vein of the eye) - Answer: HTN retinopathy

intraocular pressure (IOP) - Answer: Fluid pressure inside the eye; measured

with tonometry

Rovsing sign - Answer: pain in the RLQ when the LLQ is palpated (indicative of

appendicitis)

Pencil-like stools occur in an obstruction of what - Answer: Sigmoid descending

colon It's a thin narrow stool and possible causes include colon cancer, diarrhea, IBS. Refer for GI colonoscopy

headache after trauma - Answer: SDH

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

Vitamin B12 - Answer: Folate shares a close relationship with this other B

Vitamin.

Vitamin B12 - Answer: Cognitive deficits, glossitis, pernicious anemia,

Folate shares a close relationship with this other B Vitamin. 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

Which medication causes low sperm count for a patient - Answer: SSRI

grandiosity - Answer: Exaggerated belief in or claims about one's importance or

identity. Bipolor

ADHD - Answer: A behavioral problem characterized by short attention span,

restless movement, and impaired learning capacity. pt. pap's smear noted with Low Grade Squamous Intraepithelial Lesions and High Grade Squamous Epithelia Lesion noted on the report, what should NP do? -

Answer: HPV test if not done. Refer for colposcopy

Chlamydia trachomatis - Answer: Doxycycline (+ ceftriaxone for gonorrhea

coinfection)

Genital warts treatment - Answer: Cryotherapy

OR

Podophyllotoxin cream - OR Imiquimod (Aldara cream) HIV pt. with antiviral and CD4 count still less than 200. What should NP tell the pt.

• Answer: tell the pt. that he is qualified to be diagnosed with AIDS according to CDC

Most common cause of death in children - Answer: motor vehicle

Tanner 2 - Answer: Tanner 2- female breast bud areola develops Male testes

scrotum start to enlarge, scrotum gets darker

Tanner 4 - Answer: Tanner 4- female nipples and areola become elevated from

breast, secondary mound Male penis grows wider grows in length, darker scrotum pt. expericieng memory loss, and increase in confusion and she has a history of

stroke, HTN, What type of Alzheimer. - Answer: vascular dementia

presbycusis - Answer: a gradual loss of sensorineural hearing that occurs as the

body ages a pregnant female at slightly above symphysis pubic and Fundal height is 32cm

(above the umbilical). What should be done - Answer: Ultrasound

Romberg test - Answer: cerebellar

-ask client to stand with feet at comfortable distance apart, arms at sides, and eyes closed -expected finding: client should be able to stand with minimal swaying for at least 5 seconds

Direct Coombs test - Answer: r/o bilirubin

preeclampsia treatment - Answer: bed rest, laying on her side

Molluscum contagiosum treatment - Answer: Currettage, liquid nitrogen

pyloric stenosis - Answer: non bilious vomiting, olive like firm mass palpated on

right upper quadrant horizontal nystagmus that stops when eye is close to midline in a college student -

Answer: Ménière's disease?

Nystagmus test - Answer: the involuntary jerking of the eyes as a person gazes to

the side

eating, painful lump noted on the jaw that comes and go. - Answer:

sialolithiasis).

Etopic Pregnancy: Risk Factors - Answer: 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)

Which among the list can cause increase in respiration - Answer: Options include

(low oxygen, high oxygen, hypercapnia, hypocapnia)?

Which among the list can cause increase in respiration - Answer: hypercapnia

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 to prevent fracture in a pt. with low vitamin d hydroxyl, high TSH and low Hct -

Answer: VITAMIN D 600-800, CALCIUM 1000-1200.

OSTEOPOROSIS BONE ABSORPTION EXCEED BONE FORMATION.

LOW TSH= Hyperthyroidism- BONE DEMINERALIZATION. NEED CALCIUM for BONE GROWTH

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

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

Common causes of GERD - Answer: risk factors-

alcohol, anticholinergic, CCB, BB chocolate peppermint, fatty, spicy, citrus foods, hormones, obesity, pregnancy, smoking, theophylline

Zeprexa. What lab and intervention to put in place - Answer: CAUSES ELEVATED

LIPDS, GLUCOSE, WEIGHT

monitor CBC for low WBC weight- BMI q 3m b/p, mental status, lips, prolactin, glucose

Weber test - Answer: Sensorineural loss Weber test(top of head) no laterization,

normal finding, does not lateralize to either ear, bilateral hearing loss, if hear better in left ear, right sensorineural loss

Weber test - Answer: Sensorineural loss Weber test (top of head) no laterization-

normal, does not lateralize to either ear- bilateral hearing loss, if hear better in left ear, right sensorineural loss. SUN- sensorial lateralize unaffected ear

CAFFE- Conductive lateralize to affected ear

Assessment on patient with ascites - Answer: Dullness

Assessment on patient with ascites - Answer: Dullness to percussion

Varus Stress Test - Answer: application of a lateral force to the medial aspect of a

joint in an attempt to create a gap in the lateral joint line, thereby testing the stability of the lateral aspect of the joint LCL

Varus Stress Test - Answer: TEST LCL (lateral-vaRus)

McMurrays- Meniscus CLICK application of a lateral force to the medial aspect of a joint in an attempt to create a gap in the lateral joint line, thereby testing the stability of the lateral aspect of the joint LCL

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. patient with IOP of 32mmHg, what do you expect during fundoscopic exam -

Answer:

patient with IOP of 32mmHg, what do you expect during fundoscopic exam -

Answer: increase cup-to-disc ratio

retinal hemorrhage optic nerve asymmetry and pallor measured w tonometry

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

seasonal affective disorder (SAD) - Answer: a mood disorder caused by the

body's reaction to low levels of sunlight in the winter months

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

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

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

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 >2.5

Retinoblastoma - Answer: white reflection in child's pupil

for staph aureus infection (skin) with pus - Answer: MRSA- TX Bactrim or

tetracyclines?

hyperparathyroidism - Answer: high calcium

Hyperthyroidism treatment - Answer: methimazole, PTU-propylthiouracil

(preferred in pregnancy) Radioactive iodine, Beta blockers

Mammography Screening - Answer: -Age 45 - 54 yearly mammogram

-55 and older every 2 years

Fifth's Disease (Erythema Infectiosum) - Answer: B19: lytic infection, respiratory

transmission Sx: flushed rash/fever in kids Px: fever, get better in a week pt has AOM but has hives on Amoxicillin and N/V with erythromycin, what meds

to give - Answer: TREATMENT: Amoxicillin (first line), then Augmentin, Omnicef,

Ceftin, Levaquin. If your patient is only PCN allergic do azithromycin or clarithromycin.

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

papilledema - Answer: optic disc swollen w/ blurred edges due to increased ICP

EXAM

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

Allergic Conjunctivitis - Answer: "stringy; increased tearing" PO antihistamines.

Type I sensitivity. Typically bilateral. Rhinitis and allergic shiner.

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

CN IX Glossopharyngeal - Answer: - Shoulder shrug/ ROMBERG test EXAM

CN V Trigeminal - Answer: Herpes. CORNEAL ABRASION. EXAM

CN VIII Vestibulocochlear - Answer: ears 8 EXAM

CN VII Facial - Answer: BELLS EXAM

ACEI contraindicated - Answer: pregnancy

Safe to give varicella/MMR - Answer: Do not give <12 mo. EXAM QUESTION

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.

Acne Rosacea - Answer: - chronic small acne like papules/pustules around nose

mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. Clindamycin. EXAM

Cataracts - Answer: is on EXAM in elderly night vision issues. Opaque

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

Erythema migrans - Answer: 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.