Family Nurse Practitioner Exam Questions and Answers 2024-2025, Exams of Nursing

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Answers 2024-

Sensitivity - Correct Answers ✅defined as the ability of a test to detect a person who has the disease. Specificity - Correct Answers ✅defined as the ability of a test to detect a person who is healthy or to detect the person without the disease. Trauma to Kiesselbachs plexus - Correct Answers ✅will result in an anterior nosebleed The diagnostic or gold standard test for sickle cell anemia, G6PD anemia, and alpha or beta thalassemia - Correct Answers ✅hemoglobin electrophoresis questions asking for "action" - Correct Answers ✅the initial action might be to interview and gather subjective data or the history erythromycin "allergy" vs adverse reaction - Correct Answers ✅adverse reactio-symptoms of nausea or GI upset allergy -hives, angioedema acute mononucleosis - Correct Answers ✅the patient will most likely be a teen presenting with the classic triad of sore throat, prolonged fatigue, and enlarged cervical nodes.

Answers 2024-

Alpha thalassemia - Correct Answers ✅more common among Southeast Asians such as filipinos Lupus - Correct Answers ✅present with malar rash(butterfly rash)Pts need to avoid or to minimize sunlight exposure(photosensitivity) treatment for polymyalgic rheumatica(PMR) - Correct Answers ✅first line treatment for PMR includes long-term steroids. Long term steroids are commonly used to control symptoms(pain, stiffness on shoulders, and hip girdle). PMR pts have higher risk for temporal arteritis. Gold standard exam for temporal arteritis - Correct Answers ✅biopsy of the temporal artery. refer pt to opthalmologist for mgt Finkelstein's test - Correct Answers ✅Positive in De Quervains tenosynovitis Anterior Drawer maneuver and Lachman maneuver - Correct Answers ✅Positive if anterior cruciate ligament (ACL) of knee damaged. The knee may also be unstable

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McMurray's sign - Correct Answers ✅Positive in meniscus injuries of the knee Damaged Joints - Correct Answers ✅order X-ray first, but MRI is the Gold Standard Diabetic retinopathy - Correct Answers ✅neovascularization, hard exudates, cotton wool spots, and micoaneurysms Hypertensive retinopathy - Correct Answers ✅AV nicking, silver and or copper wire arterioles Checking deep tendon reflexes - Correct Answers ✅absent(0), hypoactive (1) normal(2) hyperactive(3) clonus(4) define clonus - Correct Answers ✅Clonus is typically seen in patients with stroke, multiple sclerosis, spinal cord damage and hepatic encephalopathy. Clonus has also appeared after ingesting potent serotonergic drugs, where ingestion strongly predicts imminent serotonin toxicity (serotonin syndrome). Clonus is a series of

Answers 2024-

involuntary, rhythmic, muscular contractions and relaxations. Clonus is a sign of certain neurological conditions, particularly associated with upper motor neuron lesions involving descending motor pathways, and in many cases is, accompanied by spasticity (another form of hyperexcitability).Unlike small, spontaneous twitches known as fasciculations (usually caused by lower motor neuron pathology), clonus causes large motions that are usually initiated by a reflex. A rare but serious adverse effect of ACE inhibitors is - Correct Answers ✅angioedema A common side effect of ACE inhibitors is a - Correct Answers ✅dry cough(10%) First line drug to treat hypertension in diabetics and patients with mild renal disease because of their renal protective properties - Correct Answers ✅ACE inhibitors or ARBS Penicillin - Correct Answers ✅amoxicillin(broad-spectrum PCN) Penicillin VK Macrolide - Correct Answers ✅erythromycin, azithromycin(Z-Pack), or clarithromycin(Biaxin)

Answers 2024-

Cephalosporins: - Correct Answers ✅1st generation(Keflex), 2nd generation(Cefaclor, Ceftin, Cefzil)3rd generation(Rocephin, Suprax, Omnicef) Quinolones with gram positive coverage - Correct Answers ✅levofloxacin(Levaquin), moxifloxacin(Avelox), gatifloxacin(Tequin) Quinolones - Correct Answers ✅ciprofloxacin(Cipro), ofloxacin(Floxin) Sulfa - Correct Answers ✅trimethoprim/sulfamethazole(Bactrim, Septra), nitrofurantoin(Macrobid), Tetracyclines - Correct Answers ✅tetracycline, doxycycline, minocycline(Minocin) NSAID - Correct Answers ✅ibuprofen, naproxen(aleve, Anaprox) Cox-2 inhibitors - Correct Answers ✅celecoxib (celebrex) Antitussives - Correct Answers ✅dextromorphan(Robitussin), benzonate(Tessalon Perles)

Answers 2024-

Drugs allowed for pregnant or lactating women - Correct Answers ✅Category B Pregnancy in pain - Correct Answers ✅order Tylenol instead of Ibuprofen Avoid nitrofurantoin and sulfa drugs during 3rd trimester - Correct Answers ✅increase the risk of hyperbilirubinemia best way method of spreading viruses or bacteria is - Correct Answers ✅making them airborne or nebulized treatment of cutaneous anthrax - Correct Answers ✅Ciprofloxacin 500mg orally BID for 60 days or 8 weeks. If pt allergic to ciprofloxacin , use doxycycline 100mg BID Good communication rules - Correct Answers ✅Ask open ended questions, do not reassure patients, avoid angering the patient, and respect the patients culture. Eriksons Stages of Psychosocial Development - Correct Answers ✅Stage 1: Infancy -- Age 0 to 1 Crisis: Trust vs. Mistrust

Answers 2024-

Stage 2: Toddler -- Age 1 to 2 Crisis: Autonomy (Independence) vs. Doubt (or Shame) Stage 3: Early Childhood -- Age 2 to 6 Crisis: Initiative vs. Guilt Stage 4: Elementary and Middle School Years -- Age 6 to 12 Crisis: Competence (aka. "Industry") vs. Inferiority Stage 5: Adolescence -- Age 12 to 18 Crisis: Identity vs. Role Confusion Stage 6: Young Adulthood -- Age 19 to 40 Crisis: Intimacy vs. Isolation Stage 7: Middle Adulthood -- Age 40 to 65 Crisis: Generativity vs. Stagnation Stage 8: Late Adulthood -- Age 65 to death Crisis: Integrity vs. Despair Important primary vs secondary - Correct Answers ✅"Will performing this action prevent the disease or the social condition from happening? If it does, then it is considered as primary prevention(if it doesn, then it is secondary) breast self exam and genital self exam - Correct Answers ✅considered secondary prevention

Answers 2024-

tertiary prevention - Correct Answers ✅involves not only rehabilitation, but also includes actiivities that will help to prevent complications from disease treatment, such as patient education about medication side effects or the proper use of equipment such as cane. Support groups for a disease /condition are all considered as part of a tertiary prevention activity. Primary prevention - Correct Answers ✅(prevent disease.injury/condition)-youth violence prevention, bullying prevention, presonal safety promotion, disease prevention- immunization, using suncreen, healthy lifestyle promotion, promotion of OSHA lawas-workplace safety, EPA laws-clean water, anipollution laws secondary prevention - Correct Answers ✅(Detect disease.condition as Early as Possible) any lab test to screen disease, US preventive Services Task Force- screening rec-mammograms, PSA, PPD, screening for high risk behaviour-suicide, depression, personal action to detect cancer Tertiary prevention - Correct Answers ✅(Limiting Further harm and disability) All types of rehabilitation-cardiac, pt/ot, speech therapy , addition/drug rehab, support groups, exercise for an obese person

Answers 2024-

clue cells - Correct Answers ✅mature squamous epithelial cells with numerous bacteria noted on the cell borders(bacterial vaginosis) Bacterial Vaginosis - Correct Answers ✅has a alkaline pH(vagina normally has an acidic pH of 4.0) BV is the only vaginal condition with the only alkaline pH for the exam. BV is not considered an STD(it is imbalance of vaginal bacteria-sex partner does not need to be treated. The microscopy slide will have very few WBC and large number clue cells. Candida vaginal discharge - Correct Answers ✅white in color with a thick and curd like consistency. it frequently causes redness and itching in the vulvovagina due to inflammation microscopy in candidiasis - Correct Answers ✅will show a large number of WBC, pseudohyphae, and spores(saghetti and meatballs candida yeast - Correct Answers ✅normal flora of gastrointestinal tract and in some womens vaginas trichomonas infection - Correct Answers ✅vaginal discharge is copious, bubbly, and green in color. It causes a lot of inflammation resulting in itching and redness of the vulvvagina. It is considered a sexually transmitted infection. The sex partner needs treatment.

Answers 2024-

Gold standard of diagnosis for BV, candida vaginitis, and trichomoniasis for the exam - Correct Answers ✅microscopy is the gold standard. treatment for strep throat - Correct Answers ✅penicillin VK PO for 10 days. If pt is PCN allergy, macrolides can be used instead. mortality - Correct Answers ✅most common cause of death prevalence - Correct Answers ✅most common cause of a certain disease in a population torus palatinus - Correct Answers ✅is a benign growth of bone(an exostosis) located midline on the hard palate and covered with normal oral skin. It is painless and does not interfere with function. geographic tongue - Correct Answers ✅has multiple fissures and irrecgular smoother areas on its surface that makes it look like a topographic map. The paitent may complain of soreness on the tongue after eating or drinking acidic or hot foods leukoplakia - Correct Answers ✅is a benign variant. It appears as a slow growing white plaque that has a firm to hard surface that is slightly raised on the tongue or inside the mouth. It is considered a

Answers 2024-

precancerous lesion. It is due to chrnoic irritation of the skin or to precancerous changes on the tongue and inside the cheeks. It causes include poorly fitting dentures, chewing tobacco, and using other types of tobacco. refer for biopsy oral hairy leukoplakia(OHL) - Correct Answers ✅of the tongue is a painless white patch that appears corrugated. It is located on the lateral aspects of the tongue and is associated with HIV and AIDS infection. It is caused by Epstein-Barr virus infection of the tongue. It is considered a premalignant lesion. initial workup for ovarian cancer - Correct Answers ✅is the intravaginal ultrasound and the CA 125 risk factor for ovarian cancer - Correct Answers ✅early menarch or late menarche, nulliparity, endometriosis, PCOS, and family history of ovarian cancer. Women with BRCA 1 and 2 mutations are also at higher risk for both brest and ovarian cancer. Tanner Stages Girls - Correct Answers ✅Stage I-Prepubertal pattern Stage II-Breast bud and areola starts to develop Stage III-Breast continues to grow with nipples/areola(one mound/no separation) Stage IV- Nipples and areoola become elevated from the breast (a secondary mound)

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Stage V-Adult pattern Tanner stage Boys - Correct Answers ✅Stage I - Prepubertalpattern StageII-Testeswith scrotum starts to enlarge(scrotal skin starts to get darker/more ruggae) Stage III-Penis grows longer(length) and testes/scrotum continues to become larger Stage IV-Penis become wider and continues growing in length(testes are larger with darker scrotal skin nd more ruggae) Stage V-Adult pattern scabies - Correct Answers ✅classic location of the rashes (finger webs, waist, penis) High risk groups are health care givers, or any erson working with large populations such as schools, nursing homes, group homes, or prisons. Spread skin to skin Rash of Scarletina - Correct Answers ✅has sandpaper like texture and is accompanied by a sore throat, strawberry tongue, and skin desquamination(peeling) of the palms and soles. It is not pruritic. Impetigo rashes - Correct Answers ✅initially appear as papules that develop into bullae that rupture easily, becoming superficial, bright red weeping rashes with honey-colored exudate that becomes crusted as it

Answers 2024-

dries. The rashes are very pruritic and are located on areas that are easily traumatized, such as the face, arms or legs. Insect bites, acne lesions, and varicella lesion scan also become secondarily infected, resulting in impetigo. Cutaneous larva migrans(creepin eruption) - Correct Answers ✅rrashes are shaped like red raised wavy lines(serpinginous or snakelike) that are alone of=r few. appears maculopapular larva migrans - Correct Answers ✅the areaas of body that are commonly exposed directly to contaminated soil and sand such as soles of the feet, extremities or buttocks. are most common location treatment for larva migrans - Correct Answers ✅systemic treatment with either ivermectin once a day for 1-2 days or albendazole for 3 days first line treatment for AOM and sinusitis - Correct Answers ✅Amoxicillin 500mg po TID( for 10 days. Second line of abx is Augmentin BID or cefdinir(omnicef)BID S3 heart sounds - Correct Answers ✅indication of heart failure. The best place to listen for the S3 heart sound is the pulmonic area(the pulmonic area is near the ventricles).

Answers 2024-

for pulmonary TB - Correct Answers ✅a sputum culture is the gold standard. in Correct Answers - Correct Answers ✅are statements that are judgmental, ressuring to the patient, vague, disrespectful, or do not address the issue of suicide(or homicide) in a direct manner. First line treatment for depression - Correct Answers ✅SSRI. Second line tx TCAs. TCAs are also used as prophylactic treatment of migraine headaches, chronic pain, and neuropathic pain such as post herpatic neuralgia. Ex: amitriptyline(elavil), nortriptyline(Pamelor) do not give suicidal pt TCAs because of high risk of hoarding and overdosing. Overdose of TCAs can be fatal(cardiac and CNS toxicity) SSRI - Correct Answers ✅SSRI are firrst line treatment for OCD, generalized anxiety discorder, panic disorder, social anxiety disorder(extreme shyness) and premenstrual mood disorder(fluoxetine or Prozac) Examples of SSRI: citalopram(Celexa), ecitalopram(lexapro), fluoxetine(Prozac, sertraline (Zoloft), paroxetine (Paxil) CAGE mnemonic - Correct Answers ✅is a creening tool used to screen patients for possible alcohol abuse. Scoring two out of 4 is highly suggestive of alcohol abuse.

Answers 2024-

Thizide diuretics - Correct Answers ✅prefered for hypertension patients with osteopenia or osteoporosis. The mechanism of action of thiazide on the bone is that it decreases calcium excretion by the kidneys and it stimulates osteoclast activity that helps with bone formation Beta blockers - Correct Answers ✅are contraindicated in asthmatics or patients with chronic lung diseases such as astma , COPD, emphysema, or chonic bronchitis. ACute diverticulitis - Correct Answers ✅can be treated outpatient with ciprofloxacin 500mg PO BID plus metronidazole PO TID for 10 to 14 days Rocky Mountain Spotted fever - Correct Answers ✅South central US, classsic rash (red rash on both wrists and ankles that spread centrally with involvement of the palms and the soles) systemic symptoms-high fever, headache, myalgia, nausea. can cause death if not treated with the first 8 days of symptoms RMSF - Correct Answers ✅Dog/wood tick bite, spirochete called Rickettsia rickettsia. Treatment with doxycycline 100mg PO/IV for minimum of 7 days

Answers 2024-

Early lyme disease(erythema migrans rash stage) - Correct Answers ✅Oxodes(deer) tick bite, spirochete called Borrelia burgdorferi of the cases are in the Mid Atri. treatment with doxycycline x 21 days. Majority of the cases are in theMid Atlantic and New England states(CT, MA, NY, NJ, PA) ITP(Idiopathic thrombocytopenic purpura - Correct Answers ✅severity ranges from mild to severe(platelet count less than 30,000/) Platelets are broken down by the spleen, causing thrombocytopenia. Look for easy bruising, petechiae, purpura, epistxis, and gingival bleeding. Initial treatment for ITP is glucocorticoids(prednisone) based on platelet response. Emancipated minors - Correct Answers ✅a person under the age of 18 years who has a full legal right of an adult such as signing legal contracts and consents. Minors who are parents are not considred emancipated unless they are legally married. Minors who are single parents may give consent for the care of their children, but not for their own medical care. Criteria for emancipated minor (United States) - Correct Answers ✅Any minor who is legally married, any minor who is enlisted on active duty in the US military, a minor who has obtained emanipation through the court or a "Declaration of Emancipation"

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Estimated GFR - Correct Answers ✅better test of renal function compared with the serum creatinine concentration. A GFR value fo 60 or less is a sign of kidney damage(refer to nephrologist) The GFR is an estimated alue, it is not measured directly and is computed using the serum creatinine value in the Cockcroft-Gault(or MDRD study) equations. serum creatinine - Correct Answers ✅is affected by age(less sensitive in elderly) gender (higher in males), ethnicity (higher with African American background) and other factors. BUN - Correct Answers ✅is a waste product of the protein from foods that you have eaten. If you eat more protein before the test, it will increase(or decrease with low protein intake) Dehydration will elevate the BUN value. Liver(cytochrome P450 enzyme system) - Correct Answers ✅most active organ. Drug excretion - Correct Answers ✅almost all drugs chemicals are broken down by the liver and excreted from the body in the bile, urine, feces, respiratory gas(Co2) and as sweat. trough - Correct Answers ✅the lowest concentration fo a drug after a dose

Answers 2024-

Potent inhibitors of the cytochrome P450 system. - Correct Answers ✅These drugs are respnsible for a large number of drug -drug interactions Macrolides(erythromycin, clarithromycin, pediazole) Antifungals(ketoconazole, fluconazole) Cisapride(Proulsid) Cimetidine(Tagament) Citaprolam(Celexa) coumadin - Correct Answers ✅for A fib the target INR is from 2.0 to 3.0. INR values below 2.0 increase stroke risk sixfold vitamin K - Correct Answers ✅mayonnaise, canola oil, and soybean oil has Vitamin K Adverse effects of thiazide dieuretics - Correct Answers ✅hyperglycemia, elevated triglycerides and LDL, elevattes uric acid, hypokalemia. thiazide diuretics - Correct Answers ✅pt with both htn and osteoporosis have an extra benefit from thiazides. thiazide diuretics

Answers 2024-

decrease calcium excretion by the kidneys and stimulate osteoclasts formation. Patients with serious sulfa allergies should avoid thiazide diuretics. Potassium sparing diuretics can be used as alternative. Potassium sparing diuretics - Correct Answers ✅hypertension alternative dieuretics with severe sulfa allergy. loop diuretics. - Correct Answers ✅Edema from heart failure, cirrhosis , renal disease, hypertension. Loop diuretics are excreted via loop of Henle of the kidneys and are more motent than Hctz. Ex: Lasix, Gumetanide. Loop diuretics are more potent tha thiazides , but shorter duration of action Adverse effect of loop diuretics - Correct Answers ✅Electrolytes imblance, hypocolemia, pancreatitis, juandice, rash. ototoxicity. Aldosterone Antagonists - Correct Answers ✅Hirsuitism, htn, sever heart failure. exp spironolactone. Adverse effects are galactorrhea and hyperkalemia. Spironolactone is rarely used to treat htn in primary care due to adverse effects and higher risk of certain cancer. Beta Blockers - Correct Answers ✅HTN, post myocardial infarction(first line), angina, arrhythmias, migraine prophylaxis. Adjunct tretment-hyperthyroidism/thyrotoxicosis (decrease HR, anxiety). Migrain prophylaxis-non-cardioselective(blocks beta 1 and beta 2).

Answers 2024-

Cardio selective(blocks beta 1 only)-atenolol(tenormin), metoprolol (lopressor) Adverse effects of beta blockers - Correct Answers ✅bronchospasm, bradycardia, depression, fatigue, erectile dysfunction, blunts hypoglycemic resonse Contraindications of beta blockers - Correct Answers ✅asthma(causes bronchospasm) COPD(causes bronchospasm) Chronic bronchitis (causes bronchoconstriction) Emphysema(casues bronchoconstriction) Bradycardia and AV block(second to third degree block Ace inhibitors - Correct Answers ✅Lisinopril(Zestril) Captopril(Capoten) Benazepril(lotensin) Combination: lisinopril and HCTZ (Zestoretic) ENalapril(Vasotec) ARBs - Correct Answers ✅Valsartan(Diovan) Losartan(Cozar)

Answers 2024-2025

Irbesartan(Avapro) Potassium sparing diuretics - Correct Answers ✅Triamterene(Dyrenium) Triamterne + HCTZ(Dyazide) Amiloride(Midamor) Beta blockers - Correct Answers ✅Propranolol(Inderal) atenolol(Tenormin) metoprolol(Lopressor) pindolol(Visken) Due not discontinue beta blockers a Ace inhibitors and ARBS - Correct Answers ✅cat C (first trimestor) cat D (second and third trimestor) ACEI blocks conversion of angiotensin I to angiotensin II(potent vasocontrictor). ARBs blocks angiotensin II(less aldonsteron). ACEI suffix "pril" ARBS suffix sartan" Calcium Channel Blockers - Correct Answers ✅HTN, Raynauds phenomenon(first line) Amlodipine(Nirvasc)

Answers 2024-2025

Diltiazem(Cardizem) Nifedipine(Procardia) Verapamil(Calan. Do not mix with erythromycin and clarithromycin(drug interaction) Contraindications:AV-block(second to third degree), bradycardia, CHF Adverse effects of CCB - Correct Answers ✅headache periperhal edema(not due to fluid overload) bradycardia HF, heart block hypotension, QT prologation constipation is the most commonly reported side effect Alpha blockers - Correct Answers ✅HTN with coexisting BPH Terazosin(Hytrin) at bedtime-potent vasodilator Macrolides(cat B) - Correct Answers ✅Erythromycin PO QID Azithromycin (Z-pack) Clarithromycin PO BID Many side effects: careful with myasthenia gravis, coumadin, QT prolongation/bradyarrhythmias

Answers 2024-2025

GI distress(especially erythromyicin) Ototoxicity, cholestatic juandice QTCprolongation(risk of torsades de pointes) Cephalosporins (CAT B) - Correct Answers ✅Cephalosporins and penicillins belong to the beta-lactam family of ABX. FIRST GENERATION Cephalosporins -Activity against gram-positive bacteria. Used to treat infections caused mainly by gram positive bacteria(cellulitis, mastitis) Exp: Cephalaxin(Keflex) PO QID Pregnancy: UTI(if sensitive)pregnancy Skin:Cellulitis (not caused by MRSA) impetigo Second generation Cephalosporins - Correct Answers ✅Considered as "broad spectrum" antibiotics. Used to treat infections caused by gram positive bacteria. (sinusitis, otitis media) Cefuroxime axetil(Ceftin) PO BID ENT:Sinusitis, OM Cefprozil(Cefzil) PO BID Resp: CAP, exac chronic Bronchitis Cefaclor (Ceclor) PO BID others: AOM, sinusitis, skin infections Third generation Cephalosporins - Correct Answers ✅Less activity against gram positive infections compared to the first generation cephalosporins.

Answers 2024-2025

Better covereage for gram negative bacteria(Neisseria gonorrheae infections) and against enteric bacteria 3rd gen Ceph Ceftriaxone (Rocephine)IM STD:Gonorrhea cervicitis, urethritis, PID Cefixime (Suprax) daily to BID ENT: AOM in children, acute sinusitis, OM Cefdinir(Omnicef) daily to BID GU: pyelonephritis, CAP Penicillins (CAT B) - Correct Answers ✅There is a chance of cross reactivity, especially with firrst gen cephalosporins. Amoxicillin and ampicillin are extended spectrum penicillins. They are effective against gram positive bacteria andsome gram negative bacteria(Haemophilius influenza, Escherichia coli, Proteus mirabilis) Examples: Penicillin V PO QID Amoxicillin PO BID to TID Amoxicillin plus clavulanic acid (Augmentin) PO BID Benzathine PCN G IM Dicloxacillin PO QID Adverse reactions of PCNs - Correct Answers ✅diarrhea, c difficile, vaginitis(usualy candida)

Answers 2024-2025

First line treatment for gonorrheal infection - Correct Answers ✅Rocephine(ceftriaxone) IM first line TX for MRSA skin infections(boils , abscesses) - Correct Answers ✅do not use cephalosporins. First line tx is either trimethoprim-sulfa(Bactrim DS) BID r clindamycin TID treat for 5 to 10 days. if pt have true allergy to PCN - Correct Answers ✅they are more likely to have allergic reaction to cephalosporins(esecially 1st gen) Use PCN VK - Correct Answers ✅for mononucleosis, not amoxicillin(causes generalized rash not related to allergy) Dicloxacillin - Correct Answers ✅is for pencilinase-producing staph skin infections(mastitis and impetigo) Fluoroquinolones (Quinolones) - Correct Answers ✅effective against gram negative bacteria and some atypical bacteria(chlamydia, Mycoplasma, Legionella) Newer generation quinolones (levofloxacin , moxifloxacin, gatifloxacin) are also active against gram positve bacteria.