Download AANP EXAM /AANP ACTUAL EXAM REAL EXAM QUESTIONS AND CORRECT VERIFIED ANSWERS and more Exams Nursing in PDF only on Docsity!
AANP EXAM /AANP ACTUAL EXAM 2024
REAL EXAM QUESTIONS AND CORRECT
VERIFIED ANSWERS (100% COMPLETE
SOLUTION) NEW UPDATED VERSION |
ALREADY GRADED A+
ADA screening for DM in Children - ANSWER - >-symptomatic children (polyuria, polydipsia, polyphagia, blurred vision) regardless of risk factors
- asymptomatic children after puberty or 10 years of age or older if overweight or obese (>85th percentile). Plus 1 of the following: *T2DM in 1st or 2nd degree relative *high risk racial/ethnic group *signs of insulin resistance (HTN, dyslipidemia, acanthosis nigricans, PCOS, SGA) *maternal hx of DM or GDM during the child's gestation Statistics - ANSWER - >- leading causes of death: Heart disease, cancer, lung disease
- leading cause of cancer death: lung
- leading cause of death in adolescents: accidents
- most common cancer: skin.
- in males: prostate. in females: breast
suicide: males more successful, women more attempts. highest rate is older white males. Osgood-Schlatter: - ANSWER - >knee pain in young adults, overuse. Repetitive stress pain, tenderness, swelling at the tendon's insertion site. The tibial tuberosity. Rule out avulsion fracture if there is an acute onset and order a lateral xray. RICE. Usually stops when the growth stops. If patient has right sided weakness, etc. the CVA occurred where - ANSWER - >left side initial evaluation of symptoms of acute prostatitis - ANSWER -
Urinalysis and urine culture A 65-year-old woman presents for a follow-up examination after a new patient visit. She has not seen a healthcare provider for several years. She is a smoker and her hypertension is now adequately controlled with medication. Her mother died at age 40 from a heart attack. The fasting lipid profile shows cholesterol = 240 mg/dL, HDL = 30, and LDL = 200. In addition to starting Therapeutic Lifestyle Changes, the nurse practitioner should start the patient on:
- bile acid sequestrant.
- a statin drug.
- a cholesterol absorption inhibitor.
Basal Cell Carcinoma - ANSWER - >Pearly domed nodule with overlaying telangiectatic vessels. Could be plaque, papule, possible central ulceration and crusting. Dx: Biopsy Tx: Normal, healthy woman of reproductive age - ANSWER - >white, clear, flocculent(physiologic leukorrhea), no complaints, pH 3.8- 4.2 (toward acidic), no odor, microscopic shows lactobacilli (gram+bacteria) Multiple infections from bacteria and fungus? - ANSWER -
Screen for HIV Screening Tests - ANSWER - >- sensitivity: detect those WITH the disease. higher the sensitivity is higher the false positives
- Specificty: detect those who DONT have the disease. erythromycin for chlamydia eye infection in infants - ANSWER -
... to assess pts ability to think abstractly a nurse pract could ask the patient - ANSWER - >the meaning of a common proverb The most commonly prescribed medication for mild systemic lupus erythematosus (SLE) is:
azathioprine (AZA).
belimumab (Benlysta).
ibuprofen (Advil).
cyclophosphamide (Cytoxan). - ANSWER - >ibuprofen (advil) A 17-year-old female is suspected of having polycystic ovary syndrome. In addition to testosterone, the most appropriate diagnostic tests to order would be: - ANSWER - >follicle- stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (TSH). Barlow's Maneuver - ANSWER - >Feeling of a slip as the femoral head slips away from the acetabulum (toward the butt) (good until 6 mo) Candida vulvovaginitis - ANSWER - >etiology: candida albican (80-90%) white, curdy, "cottage-cheese" like, sometimes increased, itching/burning discharge, pH <4.5, odor is usually absent, microscopic shows mycelia, budding yeast, pseudohyphae w/KOH prep. Treatment: oral diflucan or vaginal miconazole or terconazole PSEUDOHYPHAE, CLOTRIMAZOLE CREAM Proton Inhibitors - ANSWER - >Increased risk of fractures(postmenopausal women),
lacrimal sac massage- rub down towards mouth. oral clindamycin (topical tobramycin or moxifloxacin if mild- purulent drainage, no redness) Pre-DM in children values - ANSWER - >A1C: 5.7% to 6.4% Fasting: 100- 125 2 hour GTT: 140- 199 Primary Prevention - ANSWER - >- individual actions: eating nutritious diet, exercise, seatbelts, gun safety. IMMUNIZATIONS squamous epithelial cells with stippling appearance, no lactobacilli and many WBCs is - ANSWER - >wet mount that shows BV trigeminal neuralgia manifests - ANSWER - >electric shock facial pain The most common sign of cervical cancer is:
postcoital bleeding.
strong odor from vaginal discharge.
itching in the vaginal area.
molluscum contagiosum. - ANSWER - >postcoital bleeding
To assess a patient's ability to think abstractly, a nurse practitioner could ask the patient: - ANSWER - >the meaning of a common proverb. Auspitz sign - ANSWER - >droplets of blood when scales removed = psoriasis Bacterial vaginosis - ANSWER - >etiology: unclear, likely polymicrobial, associated with G. vaginalis, M. hominid, others. thin, homogeneous, white, gray, adherent, often increased, discharge is foul odor(fishy), itching is occasionally present, pH 5 - 7(alkaline- no active bacilli in vagina), "fishy" smell, microscopic > 20 clue cells/HPF, few or no WBCs. Treatment: metronidazole topical, oral Flagyl, clindamycin vaginal cream, oral tinidazole (Tindamax) CLUE CELLS, METRONIDAZOLE GEL OR ORAL, CLINDAMYCIN CREAM Omeprazole (Prilosec) - ANSWER - >interacts with with Warfarin (Coumadin), diazepam (Valium), Carbamazepine (Tegretol), Pheytoin (Dilantin), ketocanazole (Nizoral) Viral Conjunctivitis tx - ANSWER - >Antihistamine, decongestant drops (Trigluridine in herpes conjunctivitis)
The nurse practitioner prescribes amitriptyline (Elavil) for a patient with neuropathic pain secondary to diabetes mellitus. On follow-up, the patient complains of urine retention and dry mouth. The practitioner would:
discontinue amitriptyline and begin ibuprofen (Motrin).
refer to physical therapy.
start methocarbamol (Robaxin).
discontinue amitriptyline and begin gabapentin (Neurontin). - ANSWER - >discontinue amitriptyline and begin gabapentin (neurontin) To assess spinal function at the S1 level, which deep tendon reflex should be tested? - ANSWER - >Achilles Herald patch + christmas tree - ANSWER - >pityriasis rosea Secondary Prevention - ANSWER - >- screening tests (pap, mammogram, CBC). Strep Pharyngitis tx - ANSWER - >PCN, amoxicillin, macrolide, cephalosporin Vitamin K Agonist Warfarin (Coumadin) - ANSWER - >Interactw with "G" hers:
Garlic Ginger Gingko Ginseng Other herbs/supplemts: Feverfew green tea fish oil **Discontinue 7 days before surgery What is the gold standard test for sickle cell anemia, glucose- 6 - phosphage dehydrogenase (G6PD) anemia, and alpha or beta thalassemia?? - ANSWER - >Hemoglobin electrophoresis Postherpetic neuralgia - ANSWER - >Tx: Prophylaxsis TCA-Elavil Atrophic vaginitis (genitourinary syndrome of menopause GSM)
- ANSWER - >etiology: estrogen deficiency (after menopause). D/C scant, white-clear dryness as well sometimes urinary incontinence, itching/burning, discharge but often w/o symptoms, pH >5 (little to no lactic bacilli), odor is absent, microscopic few or absent lactobacilli. Treatment: topical and/or vaginal estrogen if symptomatic and/or recurrent UTI. (Oral estrogen as solo intervention likely inadequate)
diagnoses (such as colonic neoplasia) and to evaluate the extent of the diverticulosis. Recomendations for surgery: Patients in whom elective surgery has been recommended following a single attack of diverticulitis include younger patients (variously defined in the literature as less than 40 or 50 years of age) and those who are immunosuppressed. Neuroblastoma- - ANSWER - >painful abd mass fixed first irregular, crosses midline. Most common side is adrenal glands. Weight loss fever. HORNERS syndrome. RACOON eyes, bone pain, HYPERTENSION. 1-4 year olds. Dx ultrasound PUNT to nephro. NEURO think brain in middle crosses midline. **Urine catecholamines and anemia ADHD - ANSWER - >hyperactivity, impulsive and/or inattention. DSM-5 Criteria: *sx present before 12 years of age *sx for at least 6 months *sx in 2 different settings Medications considered 1st line if over 6 years of age TZD Pioglitazone (Actos) - ANSWER - >Black Box warning: cause or exacerbate congestive heart failure in some patients; do not. use if New York health association Class III or IV Heart failure
STOP if causes dyspnea, weight gain, cough (heart failure) in order to improve longevity of patient with COPD, tx of choice is - ANSWER - >oxygen current social relationships, history of present or past traumas mental health status - ANSWER - >all important on the pe of 21 yo, for employment with bruising on breasts A 17-year-old male with rheumatoid arthritis is being treated with an NSAID and omeprazole (Prilosec). The patient complains of headache, abdominal pain, and gas. These symptoms are most likely:
associated with the omeprazole.
related to the underlying condition.
the result of the NSAID.
caused by viral gastroenteritis. - ANSWER - >associated with the omeprazole Koplick Spots - ANSWER - >white with red ring inside cheek from rubeola or mumps
with recurrence symptoms vary- asymptomatic transmission common treatment: oral acyclovir (Zovirax), famciclovir (Famvir), valacyclovir(Valtrex), dose and length of treatment depends on the medication choice and the clinical presentation. Diverticulosis: Treatment s/s: - ANSWER - >Diverticu-lO-sis has nO inflamation: Both diverticulitis and *osis are similar to umbilical hernia in that a vein running through the muscle of the bowel muscle weakens the area and pressure causes a hernia "out pouching". RETINOBLASTOMA - ANSWER - >leukocoria: Hallmark sign white spots in eye. Cancer. Red light reflex negative What are first and second line antibiotics for acute otitis media? - ANSWER - >1. Amoxicillin
- Amoxicillin-Clavulanate (Augmentin) Screening Tests: - ANSWER - >- Breast Cancer: 50yrs q2years until 75yo. (40-49 is individualized)
- Cervical Cancer: 21yrs q3yrs until 65y. no screening after hysterectomy
- Colorectal Cancer: 50yrs until 75. FOBT x3 yearly. Flex sig q5yrs OR colonoscopy q 10yrs
- Lipids: men >35y and women >45y. unless increased risk for heart disease
- Prostate: don't screen
- Skin Cancer counseling: 10-24yo with fair skin
which of the following criteria differentiates a TIA from a CVA - ANSWER - >absence of residual symptoms - TIA sx occur rapidly and then resolve, CVA sx are residual - TIA is temporary block and usually no residual sx CD4 count and viral load - ANSWER - >most widely accepted indicators of HIV infection The medication of choice for the initial treatment of juvenile rheumatoid arthritis is:
acetaminophen.
prednisone.
aspirin.
ibuprofen. - ANSWER - >ibuprofen Which of the following laboratory tests are most widely accepted as indicators of the progression of HIV infection? - ANSWER - >CD4 count and viral load slapped cheek and lacy exanthem - ANSWER - >Erythema Infectiosum or Fifths disease Intertrigo tx - ANSWER - >Nystatin
ABUNDANT WBCs Bacterial vaginosis: s/s and treatment - ANSWER - >Clue cells such as: stipling of squamous epithelial cells with indistinct borders, no lactobacillus rods, many white blood cells Nonpregnant women Drugs — Metronidazole or clindamycin administered either orally or intravaginally results in a high rate of clinical cure ( to 80 percent at four weeks of follow-up) (table 4) [88-91]. Oral medication is more convenient, but associated with a higher rate of systemic side effects than vaginal administration. Side effects of metronidazole (oral or vaginal) include a metallic taste, nausea (in 10 percent of patients), transient neutropenia (7.5 percent), a disulfiram-like effect with alcohol, prolongation of International Normalized Ratio in patients taking vitamin K antagonists (eg, warfarin), and peripheral neuropathy. Erythema infectiosum - ANSWER - >(5th disease)- "slapped cheeks" 5-14 y.o. LACY, spreads to upper arms lgs trunks dorsum of hands and feet. Rash can last up to 40 days. Fever, rash, runny nose, headache. EXAM humanparovirus19, no labs for it. Most common bacterial pathogen causing pneumonia - ANSWER - >strep pneumoniae, but most pathogens 6 months to 5 years are viral
Biphosphonates: Alendronate (Fosamax) Risedronate (Actonel) - ANSWER - >Erosive esophagitis, abdominal pain, Stop immediately if symptoms: esophagitis (chest pain, difficulty swallowing, burning (mid back) jaw pain (osteonecrosis) Contraindicated: Active GI disease (GERD, PUD), CKD, esophageal stricture/varices prednisone - ANSWER - >management of polymalgia rheumatica A 12-year-old with sickle cell anemia has recently experienced a sickle cell crisis and presents for a follow-up examination after a recent hospitalization. It is most important to continue monitoring growth, development, and:
white blood cell levels.
fecal occult blood test.
hemoglobin levels.
urine dipsticks. - ANSWER - >hemoglobin levels
