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AANP FNP CERTIFICATION BRAND NEW!! (QUESTIONS
AND CORRECT ANSWERS) VERIFIED ANSWERS
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 goats 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 wont 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
Lipid level of 1500, increased risk for? - ANSWER - >Pancreatitis Low HGB, Low HCT, High MCV indicates what? - ANSWER -
Macrocytic anemia, B12 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
Treatment for Gonorrhea? - ANSWER - >Rocephin 250mg IMx 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
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
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
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
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. Retinoblastoma - ANSWER - >white reflection in child's pupil
