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AANP FNP 202 4 - 2025 FINAL EXAM WITH 1000+
QUESTIONS AND VERIFIED CORRECT ANSWERS
GRADED A+
ADA screening for DM in Children
- 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
- 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: 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 left side initial evaluation of symptoms of acute prostatitis 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
Which of the following laboratory tests should a nurse practitioner order when the suspected diagnosis is temporal arteritis? Erythrocyte sedimentation rate (ESR) What are narrow therapeutic index drugs?
- Warfarin sodium (Coumadin): monitor INR
- Digoxin (lanoxin): monitor digoxin level, EKG, electrolytes(potassium, magnesium, calcium)
- Theophylline: monitor blood levels
- Carbamazepime (Tegretol) and Phenytoin (Dilantin): Monitor blood levels
- Levothyroxine: Monitor TSH
- Lithium: Monitor blood levels, TSH (risk of hypothyroidism) Otitis Externa tx Fluoroquinolone & Polymyxin B cortisporin drops An elderly male patient complains of a new-onset, left-sided temporal headache accompanied by scalp tenderness and indurated temporal artery. The NP suspects temporal
arteritis. What screening test would you order to assist with diagnosis? sedimentation rate (expect to be very elevated) Basal Cell Carcinoma 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 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? Screen for HIV Screening Tests
- 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
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: follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (TSH). Barlow's Maneuver Feeling of a slip as the femoral head slips away from the acetabulum (toward the butt) (good until 6 mo) Candida vulvovaginitis 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
Increased risk of fractures(postmenopausal women), Pneumonia, Clostridium difficile infection, hypomagnesemia, B and iron malabsorption, atrophic gastritis, and kidney disease Bacterial Conjunctivitis tx Eye drops or ointment: Polytrim, trimethoprim, polymyxin, macrolide A patient with an elevated WBC (>11k) accompanied by neutrophilia (>70%) and the presence of bands is what kind of shift and prognosis?
- Shift to the left
- Serious bacterial infection Actinic Keratosis Rough flat, dry crusty, erythematous papules or plaques. Scaly patch of red brown skin caused by years of SUN exposure. Precursor to squamous cell carcinoma. Dx. Biopsy. Tx: topical 5 fluroracil 5-FU, cryotherapy. A patient with macular degeneration has deficit vision in? Central vision
squamous epithelial cells with stippling appearance, no lactobacilli and many WBCs is wet mount that shows BV trigeminal neuralgia manifests 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.** postcoital bleeding To assess a patient's ability to think abstractly, a nurse practitioner could ask the patient:
the meaning of a common proverb. Auspitz sign droplets of blood when scales removed = psoriasis Bacterial vaginosis 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) interacts with with Warfarin (Coumadin), diazepam (Valium),
Central clearing lesion after camping trip flu like symptoms with muscle aches for several days is? and treated by? Lyme disease; doxycycline Wilms tumor (Nephroblastoma)- Not painful. Asymptomatic abd mass does NOT cross the midline. 2-3 y. o.d. do not palpate. Do ABD US. PUNT. Think Nephro doesn't cross. Stays where kidney is. the headache of an intracranial tumor focal neurological signs and pain worse in supine position socioeconomic status not important during employment physical with 21 yo with bruising on breasts 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: 1.
**discontinue amitriptyline and begin ibuprofen (Motrin).
refer to physical therapy.
start methocarbamol (Robaxin).
discontinue amitriptyline and begin gabapentin (Neurontin).** discontinue amitriptyline and begin gabapentin (neurontin) To assess spinal function at the S1 level, which deep tendon reflex should be tested? Achilles Herald patch + christmas tree pityriasis rosea Secondary Prevention
- screening tests (pap, mammogram, CBC). Strep Pharyngitis tx PCN, amoxicillin, macrolide, cephalosporin Vitamin K Agonist Warfarin (Coumadin)
Atrophic vaginitis (genitourinary syndrome of menopause GSM) 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) Diverticulitis: Treatment s/s: Antibiotics and clear liquids and increased fiber (some say no nuts or seeds). (7 to 10 days ABT) Ciprofloxacin (500 mg PO twice daily) plus metronidazole ( mg PO three times daily). Amoxicillin-clavulanate (875/125 mg twice daily) is an acceptable alternative. The criteria for patients with acute uncomplicated diverticulitis to
be treated in the outpatient setting include: ●Reliability to return for medical reevaluation if condition worsens ●Compliance with outpatient treatment plan ●Abdominal pain is not severe ●No higher than a low-grade fever ●Can tolerate oral intake ●No or minimal comorbid illnesses ●Available support system Approximately six weeks following the resolution of symptoms of acute diverticulitis, patients who have not had a recent
*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) 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 oxygen current social relationships, history of present or past traumas mental health status
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.** associated with the omeprazole Koplick Spots white with red ring inside cheek from rubeola or mumps
