Download ANCC FNP Boards Exam Review (2024/ 2025) | Questions and Verified Answers | LATEST UPDATE and more Exams Nursing in PDF only on Docsity! ANCC FNP Boards Exam Review (2024/ 2025) | Questions and Verified Answers | LATEST UPDATE 1. Treatment for polymyalgia rheumatic ~ Answer: low dose prednisone for 3 monthIto 3 years as this is a self- limiting illness 2. 3rd trimester pregnancy normal cardiac changes ~ Answer: systolic ejection murmur d/tIincreased stroke volume d/t incr eased cardiac output/higher basal heart rate,Ilaterally displaced apical i mpulse, louder s1 and s2. 3. Advice for two consecutive daysIofImissingIoralIcontraceptive pills ~ Answer:I2IpillsItoday,I2Ipills tomorrow, continue the pack and use ofI condomsIto prevent pregnancyIand stis 4. How doesIoneIdistinguish betweenIanIabd wall mass vs. An intra-abdominal mass? ~ Answer: abdIwall mass (typically a hernia) will become more promin ent with tensing the abd wall muscles. IfIit is an intra- and mass it will be pressed down and become more obvious upon tens ingIthe abd muscles. 5. Relative contraindication for coc ~ Answer: depression 6. Absolute contraindications for coc ~ Answer: hepatoma ofIthe liver, hx embolic episodes, undiagnosed vag inal bleeding. 7. Referrals to specialists or rehab are considered what typeIofIrelationship? ~ Answer: collaborative 8. How many wet diapers should a full-term infantIhaveIperI24 hrs? ~ Answer: 6Ito 10 diapers 9. Most common childhood cancer ~ Answer:Iall (acuteIlymphoblastic leukemia) 10. Is tlc (total lungIcapacity) higherIorIlower in copd? ~ Answer: conventionally, lung hyperinflation is said to exist when the t otal lung capacity (tlc) is >120% ofIthe predicted value. Marked elevat ion ofIthe tlc usually means that increased lung compliance, as a result IofIemphysema, is a primary determinant ofIlung hyperinflation. 11. Testing for celiac dz ~ Answer: ttg (tissue transglutimase iga antibody) also consider antiglia din iga and igg 23. Prior to starting atypical antipsychotics what lab tests should be obtained? What ae wil l you monitor for? ~ Answer: fasting blood glucose, fasting lipid profile, weight. These me ds will increase lipid profile and increase risk of obesity, hyperglycemi a and dmii. Watch for hypotension and sedation. 24. 1st line drug class for ocd (obsessive-compulsive disorder) ~ Answer: ssri 25. Benzodiazepine with the shortest ½Ilife ~ Answer:Itriazolam 26. Rhogam (rh (d)IimmuneIglobulin) prevents... ~ Answer:Irhesus disease (hemolytic disease ofIthe newborn). It's a solu tion ofIigg anti- d antibodies thatIsuppresses the mother's immune system from attackin gIrh-positive bloodIcells 27. 1st line gout therapy ~ Answer: indomethacin 50mg tid prn and colchicine (anti- inflammatory) 1.2 mg at onset ofIsymptoms and 0.6mg 1 hr laterIon d ay one, 0.6mg bid until symptoms resolve. Colchicine can be taken dai ly for prophylaxis. 28. Se ofIcolchicine ~ Answer: gi upset: abd pain, nausea, diarrhea 29. Ccb side effects ~ Answer: ha, peripheral edema, dizziness,Iflushing, weakness 30. Meds contraindicated in g6pd deficiency anemia (name 7 meds/classes) ~ Answer: risk ofIhemolysisIwithItheIfollowing: nitrofurantoin, sulfa, ns aids, anti-malarials. 31. Contraindications to loopIdiuretics (nameI3) ~ Answer: low b/p <90mmhg,IsevereIhyponatremia/hypokalemia, acidos is 32. WhatI3Iagents are used for prophylaxis ofIpneumocystis jirovecii pna ~ Answer:Ibactrim,Idapsone, aerosolized pentamidine 33. Meds for migraine prophylaxis ~ Answer: propranolol, timolol, amitriptyline, divalproex, sodium valpro ate, topiramate 34. How long is a full therapeutic trial for migraine prophylaxis? ~ Answer: 2-6 months 35. Moderate dose statins that can be ramped up to high dose. ~ Answer: rosuvastatin 5-10mg ~ Atorvastatin 10-20mg 36. High dose statin therapy ~ Answer: rosuvastatinI20-40mg ~ Atorvastatin 40-80mg 37. Symptoms ofIacute drug-induced hepatitis (statin therapy) ~ Answer: dark coloredIurine,Ifatigue.IAbsence ofIgeneralized muscle s oreness.IObtainIlfts 38. MuscleIsoreness in new statinIuser (isolated or generalized) ~ Answer:IckIto r/oIrhabdomyolosis 39. AnticholinergicIdrug overdose symptoms ~ Answer: flushing, fever/tachycardia, urinary retention, delirium/halluci nations, mydriasis 40. Maois (monoamine oxidase inhibitors) Answer: Answer: Answer: Answer: 53. When should you screen for autism? ~ at 18 months and 24 months 54. Contact cps for pediatric burns ~ yes 55. When will a girl start her growth spurt? ~ between tanner ii and tanner iii 56. Male physiologic gynecomastiaIisInormalIatIwhich tanner stage? ~ Answer:I14Iy/oItannerIstage iii 57. Most commonIcause of mortalityIin pediatrics ~ Answer:Iaccidental injury 58. Do the majority ofIstates require parental consent or notification for abortion? ~ yes 59. Ast and alt approx norms ~ Answer: 0-40 60. Dose ofItetanus immune globulin (tig) ~ Answer: 250 units im 61. How many doses ofItdap or td im needed for protection after clean minor wounds. ~ Answer: three doses needed. IfI<3,Iunknown, or >10 years since last dose give dose ofItdapIorItdIfor cleanIminor wounds. No need to give tig. 62. Non- "clean" minor wounds givenIboth ofItheseIifIunknown tetanus hx or <3 doses ofItdap/t d. ~ Answer:ItdapIorItdIimI&Itig 63. DirtyIwoundsI(puncture, crushIinjury, soil, saliva, feces, dirt, avulsions, missiles, burns, frostbite) ~ Answer:IifI<3Idoses tdap or td give both tdap and tig 250 units. IfI3 d oses in past,Ibut none in the last 5 years then given tdap or td. No nee d to give tig ifI3 or > doses in the past 64. When to switch from dtap to tdap in children ~ Answer: age 7 or > given tdap 65. A woman becomes pregnant and received tdap during her last pregnancy 1 year ago. When should she receive her next dose. ~ Answer: tdap is recommended for each pregnancy. ~ "getting tdap between 27 through 36 weeks of pregnancy is 78% more effective at preventing whooping cough in babies younger than 2 mon ths old (cdc)". 66. A person with a hx ofIanaphylaxis to neomycin should avoid which immunizations (iz) ? ~ Answer: ipv, mmr, varicella 67. A person with a hx ofIanaphylaxisItoIneomycin should avoid which immunizations (iz) ? ~ Answer: ipv, vaccinia (smallpox) 68. A person with a hx ofIanaphylaxis to bakersIyeast should avoid which immunizations ( iz)? ~ Answer:IhepatitisIb 69. A person with aIhx ofIanaphylaxis to gelatin should avoid which immunizations (iz)? ~ Answer: varicella zoster (zostavax) and mmr 70. Epinephrine needs to be on hand for potential anaphylaxis r/t immunization rxn. What other interventions/meds should be considered during anaphylaxis? ~ Answer: wbcs >20,000 (think through common causes ofIleukocytosis : infection, stress, inflammation) -- > get a peripheral smear (aka manual diff) ~ IfIwbcs >20,000 and with associated anemia; thrombocytopenia; throm bocytosis; enlarged liver, spleen, or lymph nodes; or constitutional sy mptoms. 82. Which 2 chronic childhood diagnoses are associatedIwith all and aml? ~ Answer: downs syndromeIand neurofibromatosis 83. What are 3 main risk factors for leukemia ~ Answer: radiation (equivalent to 2 to 3 cts),Itoxin /household pesticide exposure in utero/earlyIchildhood. 84. Acute leukemia: all orIaml cancerIandIsymptoms/pe findings ~ Answer: 2 types:Iacute lymphoblastic leukemia or acute myelogenous leukemia. ~ Blasts onIperipheral smear/bone aspiration in both all and aml. ~ Aml also presents with ~ Auer rods on peripheral smear. ~ Acute leukemia can also present with leukopenia, combined with anem iaIorIthrombocytopenia ~ Children: fever, lethargy, bleeding, potentially spinal or long bone pain . Enlarged spleen, liver, lymphandenopathy. ~ Adults (typically young): fever, fatigue, wt loss. May have anemia rela ted symptoms (chest pain, sob) 85. Chronic leukemia ~ Answer: presents in adulthood. Predominant cell is mature but does n ot function normally, cml (chronic myelogenous leukemia) and cll (chr onic lymphocytic leukemia) ~ Look for hepatosplenomegaly and splenomegaly. ; some adults are asy mptomatic. Wbcs 20,000 to 100,000 86. Which type ofIleukemia presents with the philadelphiaIchromosome (bcr- abl1 fusion gene)? ~ Answer: chronic myelogenous leukemia 87. Which type ofIleukemia is most likely to present in older adultsI>/=I65y/o? ~ Answer: cllI(chronic lymphocytic leukemia) 88. In suspected leukemia,IwhatIlabIworkIotherIthan cbc should you obtain? ~ Answer: serum electrolyte and creatinine levels, lfts, and coagulation studies. ~ IfItheIpatient appears ill or is febrile, the physician should evaluate for IinfectionIwithIurinalysis, urine culture, blood cultures, and chest radio graphy. ~ The next step in diagnosis involves a peripheral blood smear and usual ly a bone marrow specimen (an aspirate or core biopsy). 89. Normal results for tibc are... ~ Answer: 250 to 450 mcg/dl for men and women. 90. A normal platelet count ranges ~ Answer: 150,000 to 450,000 platelets per microliter ofIblood. 91. Non-hodgkin's lymphoma (nhl) s/s ~ Answer: enlarged lymph nodes, fatigue,IweightIloss and fever ~ More than 67 types ofInon- hodgkin lymphoma; more commonIthan hodgkins. ~ Impacts lymphocytes. MostIcases present >/= 55 y/o, canIpresent in ch ildren. Typically diagnosedIatIaIlaterIstage than non- hodgkins, no reed-sternberg cellsIare identified. 92. Hodgkin's lymphoma s/s ~ Answer: enlargedIlymph nodes,Ifatigue,Iweight loss , fever, night swe ats ~ ImpactsIlymphocytes.IMedianIage 39y/o, often diagnosed in early stag e, arise inIupper body (neck, chest, armpits, groin). Reed- sternberg cellsIare present. 93. The main difference betweenIleukemia and lymphoma ~ Answer: in leukemia, the cancer cells are mainly in the bone marrow andIblood. ~ In lymphoma they tend to be in lymph nodes and other tissues. 94. Nt-probnp: (n-terminal-probnp) normal ranges ~ Answer: no diagnosis ofIhf: 104. Parkinson's disease --path and typical meds. ~ Answer: problem: lack ofIdopamine ~ Motor symptoms (rocks a lots to get out ofIchair): tx is to increase do pamine with levodopa. Amantadine, pramipexole ~ Non- motor symptoms: treat with anticholinergics to alleviate tremor (restin g) and rigidity. Trihexyphenidyl, benztropine 105. Myerson sign (glabella tap reflex) common in whichIdz? ~ Answer:Iparkinson'sIdz.IThey will blink every time you tap over the b ridge ofIthe nose. 106. Alzheimer'sIdiseaseIpathophysiology, s/s, most commonly prescribed meds ~ Answer: lackIofIacetylcholine ~ Aphasia, apraxia,Iagnosia. ~ Donepezil (aricept)IisIapproved to treat all stages ofIthe disease. It's ta kenIonceIaIday asIa pill. ~ GalantamineI(razadyne) is approved to treat mild to moderate alzheim er's. ... ~ Rivastigmine (exelon) is approved for mild to moderate alzheimer's dis ease. 107. The philadelphia chromosome is associated with what disease? ~ Answer: philadelphia chromosome (ph): the chromosome abnormality that causes chronic myeloid leukemia (cml). 108. Dm ii criteria ~ Answer: 2 hr post ogtt 75gm load blood glucose >/=200mg/dl, rando m plasma glucose >/=200mg/dl, fasting plasma glucose >/=126mg/dl, hga1c >/= 6.5% 109. Independent variable ~ Answer: being manipulated in theIstudy; it is not affected by the other variables in the study. 110. Dependent variable ~ Answer: theIvariableIthatIchanges depending on the manipulation ofIt he independentIvariableIinIaIstudy 111. Name the triadIofIintussusception ~ Answer: currantIjelly stools, sausage-like mass, pain. 112. WhatIpercentage ofIintussusception cases present without the full classic triad o fIsymptoms? ~ Answer: ⅓ ofIpatients do not pass blood or mucus or develop abdomi nal mass 113. Name and quantify gina's 4 clinical classifications ofIasthma severity ~ Answer: intermittent= fev1 >80% predicted ~ Mild persistent = fev1>80% predicted ~ Moderate persist=fev1 60-80% predict ~ Severe persist= fev1 <60% predicted 114. Mtts ~ Answer: medial tibial stress syndrome/fracture aka shin splints; comm on in run/jump sports. Typically correlates withIsudden increase in trai ning. Focal pain and tenderness @Ithe medial tibia present with both. Tx: rice. Pain at rest = likely fracture; get an mri as plain film will not show stress fx. Refer to ortho ifIfxIpresent. 115. Span ofInormal adult liver inIcm ~ Answer:I6ItoI15 cmIinImidclavicular line. ~ Typically <12cm in mdlIbutIup to 15cm is normal. 116. Next steps forIpregnantIprimigravidaIwith low afp, low estriol and high hcg ~ Answer: orderIultrasound to eval for down's syndrome as these are cla ssic findings. 117. Ddx syncope ~ Answer: arrhythmia, vasovagal, hypoglycemia, orthostatic hypotension ,Isz, accidental fall, etc. 118. Somogyi effect ~ Answer: high glucose upon waking caused by a hypoglycemic event a t 2 or 3am which induces glucagon release ~ Answer: softening ofIthe lower portion ofIuterus; probable sign ofIpre gnancy 130. What is contraindicated in placenta previa? ~ Answer: pelvic exams, rectal exams or tvus. Avoiding activities that might cause contractions, including havingIsex, douching, using tampo ns, or engaging in activities that canIincreaseIyour risk of bleeding, su ch as running, squatting, and jumping. 131. Symptoms ofIplacenta previa ~ Answer: bright redIblood in the 2nd trimesterIorIlaterIwithout pain 132. Atypical pna radiologicalIpatternIincludes... AtypicalIpna etiologies include... ~ Answer:IpatchyIinflammatory changes, often confined to the pulmonar y interstitium. AtypicalIbacterial etiologies such as mycoplasma pneum oniae, chlamydophila pneumoniae and legionella pneumophilia. Viral a nd fungal pathogens may also create the radiological and clinical pictu re of atypical pneumonia. 133. VitaminIsupplementation ofI should be recommended for all brea stfed infants onItheir 1st pcp visit ~ Answer: 400 iu/day ofIvitamin d; decreases the risk ofIrickets. Recom mend otc multivitamin supplement or vitamin d supplement. 134. After tia (resolution ofIsymptoms within minutes to 2 hrs) what is the approxim ate risk ofIstroke? ~ Answer: 10-20% ofIpatients will have a stroke in 90 days. 135. Cluster ha ocular symptoms. Also list the typical length ofIha. ~ Answer: miosis (constriction), ptosis, tearing. 15-180 minutes. 136. What risk is associated with maois and aged/fermented foods (high in tyramine) ~ Answer: htn crisis 137. Metformin contraindications/precautions ~ Answer: renal,Ihepatic,Ietoh, conditions r/tIhypoxia (cardiac/pulmonar y), sepsis/dehydration (r/tIriskIofIlactic acidosis), advanced age. 138. What is myxedema? ~ Answer: "myxedema is a term generally used to denote severe hypoth yroidism. MyxedemaIis also used to describe the dermatologic changes thatIoccurIin hypothyroidism and occasionally hyperthyroidism. In thi sIsetting,Imyxedema refers to deposition ofImucopolysaccharides in th e dermis, which results in swelling ofIthe affected area. When skin ch anges occurIin hyperthyroidism, mostly graves disease, it's called preti bial myxedema"- medscape 139. What tool should be utilized to diagnose fibromyalgia? ~ Answer: widespread pain index (american college ofIrheumatology) 140. What wpi score and ss scale score is diagnostic for fibromyalgia? ~ Answer: a patient is diagnosed with fibromyalgia ifIthe following thre e conditions are met: ~ The wpi score is 7 or higher and the ss scale score is 5 or higher or th e wpi is 3-6 and the ss scale score is 9 or higher ~ The symptoms have been present at a similar level for at least 3 mont hs ~ The patient does not have another disorderIthat would otherwise explai n his or her pain