AANP FNP CERTIFICATION EXAM 2024-2025 UPDATE ACTUAL EXAM ALL QUESTIONS AND CORRECT DETAILE, Exams of Nursing

Download AANP FNP CERTIFICATION EXAM 2024-2025 UPDATE ACTUAL EXAM ALL QUESTIONS AND CORRECT DETAILE and more Exams Nursing in PDF only on Docsity! AANP FNP CERTIFICATION EXAM 2024-2025 UPDATE ACTUAL EXAM ALL QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) 100% PASS SOLUTION /AL READY GRADED A+ 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 3,4,6 Definition of metabolic syndrome - ANSWER>>cluster of conditions that increase risk of heart disease, stroke, diabetes. diagnose trichomoniasis - ANSWER>>wet prep Elderly presents with atrophic vaginitis, small uterus, palpable 4x5 ovary, what do you do next? - ANSWER>>Pelvic US Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located? - ANSWER>>Anterior septum Definitive diagnosis of acute bacterial prostatitis - ANSWER>>urinalysis and culture GERD treatment - ANSWER>>H2 is first line, give hs Grade 3 cells on Pap, treatment? - ANSWER>>LEEP excision Fingernail hematoma treatment? - ANSWER>>drill hole and drain blood? Signs and symptoms of Roseola (6ths disease) ? - ANSWER>>Viral infection Can result in a maculopapular rash, but up to 70% of cases proceed without the rash stage -Usually accompanied by a high fever (41°C or 105°F) that comes on quickly and lasts up to 3 days followed by rash -Seizures may occur during this period. -On the fourth day, the fever disappears and the rash appears, first on chest and trunk, then less prominently on the face and limbs. -High fever, pink flat or raised rash Treatment for chronic alcoholism: - ANSWER>>12 step program Treatment for Gonorrhea? - ANSWER>>Rocephin 250mg IMx1 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 increase blood pressure in arms, and lower pressure in lower legs. -congenital cardiac condition characterized by a narrowing of the aorta - Murmur Grade III - VI - ANSWER>>Loud murmur easily heard JVD caused by - ANSWER>>-tension pneumothorax, -Rt. sided heart failure, -cardiac tamponade, -traumatic axphysia from Increase in portal pressure(LIVER) in venous side or cor pulmonale pt. with gradual onset of fever, hemorrhages on nail beds, painful raised red nodules, rash on palms - ANSWER>>endocarditis , painful red spots on fingers olser's nodes, janeway legions rash on palms and soles. Know the difference between Peripheral Arterial Disease and Chronic Venous Insufficiency or PVD. There was question about PAD. - ANSWER>>PAD: Absence of pulse, decrease blow flowing down, PAIN, Dx doppler or ABI<0.9, TX exercise by walking or antiplatelet, PVD: Volume, edema, discoloration, decrease blood going up, 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 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 history of infertility use of assisted reproductive technology, such as in vitro fertilization (IVF) Which among the list can cause increase in respiration - ANSWER>>Options include (low oxygen, high oxygen, hypercapnia, hypocapnia)? Which among the list can cause increase in respiration - ANSWER>>hypercapnia Osteoporosis Risk Factors (ACCESS) - ANSWER>>A-lcohol Use C-orticosteroid Use C-alcium low E-strogen low S-moking S-edentary lifestyle/s ACCESS leads to OSTEOPOROSIS to prevent fracture in a pt. with low vitamin d hydroxyl, high TSH and low Hct - ANSWER>>VITAMIN D 600-800, CALCIUM 1000-1200. OSTEOPOROSIS BONE ABSORPTION EXCEED BONE FORMATION. LOW TSH= Hyperthyroidism- BONE DEMINERALIZATION. NEED CALCIUM for BONE GROWTH 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 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 >2.5 Retinoblastoma - ANSWER>>white reflection in child's pupil for staph aureus infection (skin) with pus - ANSWER>>MRSA- TX Bactrim or tetracyclines? hyperparathyroidism - ANSWER>>high calcium Hyperthyroidism treatment - ANSWER>>methimazole, PTU-propylthiouracil (preferred in pregnancy) Radioactive iodine, Beta blockers Mammography Screening - ANSWER>>-Age 45 - 54 yearly mammogram -55 and older every 2 years Fifth's Disease (Erythema Infectiosum) - ANSWER>>B19: lytic infection, respiratory transmission Sx: flushed rash/fever in kids Px: fever, get better in a week pt has AOM but has hives on Amoxicillin and N/V with erythromycin, what meds to give - ANSWER>>TREATMENT: Amoxicillin (first line), then Augmentin, Omnicef, Ceftin, Levaquin. If your patient is only PCN allergic do azithromycin or clarithromycin. chlamydia in pregnancy - ANSWER>>Azithromycin 1 gm PO x1 or Amoxicillin 500 mg PO TID x7d. Test of cure 3 weeks after completion of treatment (PREGO). EXAM papilledema - ANSWER>>optic disc swollen w/ blurred edges due to increased ICP EXAM actinic keratoses - ANSWER>>Precursor to squamous cell carcinoma. "numerous dry round and pink to red lesions" with a rough and scaly texture. Does not heal. Slow growing in sun exposed areas. Diagnosis: BIOPSY Golden Standard. Treatment: Sm. (cryotherapy), Lrg. (5-FU cream)- which causes ur skin to ooze, crust, scab, redness EXAM Allergic Conjunctivitis - ANSWER>>"stringy; increased tearing" PO antihistamines. Type I sensitivity. Typically bilateral. Rhinitis and allergic shiner. COPD - ANSWER>>COPD- Gold 1-2- SABA or SAMA ON EXAM.BASCIALLY ANTICHOLINERGIC FIRST LINE FOR COPD ON EXAM Gold 1-2 that are poor controlled- LAMA or LABA. May use SABA for rescue. Gold 3-4 LAMA first line. If poor use LAMA plus LABA. Alternative is LABA + ICS. Gold 3-4- refer SABA- Albuterol, levoalbuterol (terol) LABA- Formeterol, salmeterol (Terol) SAMA- Atrovent Ipatropium (tropium) LAMA- Spiriva Tiotroium (tropium) COPD long term is OXYGEN CN IX Glossopharyngeal - ANSWER>>- Shoulder shrug/ ROMBERG test EXAM CN V Trigeminal - ANSWER>>Herpes. CORNEAL ABRASION. EXAM CN VIII Vestibulocochlear - ANSWER>>ears 8 EXAM CN VII Facial - ANSWER>>BELLS EXAM ACEI contraindicated - ANSWER>>pregnancy Safe to give varicella/MMR - ANSWER>>Do not give <12 mo. EXAM QUESTION Acne Vulgaris - ANSWER>>common acne. Retin-A, acne worsens 4-6 weeks if no improvement in 8-12 weeks increase dose or add erythromycin, benzoyl peroxide. Acne Rosacea - ANSWER>>- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. Clindamycin. EXAM Cataracts - ANSWER>>is on EXAM in elderly night vision issues. Opaque Kawasaki disease - ANSWER>>- acute high fever, enlarged lymph. BRIGHT RED RASH, conjunctivitis, dry cracked lips, strawberry tongue, Swollen hands, feet, AFTER the fever resides the rash PEELS on Primary Amenorrhea - ANSWER>>Primary amenorrhea: NO menarche by 15 y. with or w/o secondary sex characteristics. Aphthous stomatitis - ANSWER>>Cancer sores. Aphthous stomatitis: painful shallow ulcers heal 7-10 days. Magic mouthwash. Temporal arteritis - ANSWER>>Temporal arteritis- one temple indurated cord like gold stand. Biopsy. Abrupt visual changes blindness, inc. ESR. CPR. Most have POLYMYALGIA RHEUMATICA. Treat high dose steroids. Atopic Dermatitis (eczema) - ANSWER>>Inherited. Extremely itchy. On flexural folds, neck, hands. Inc. IgE. "small vesicles that rupture leaving painful, bright-red, weepy lesions" they become lichenified from itching. First line: Topical steroids. Avoid hot water/soaps. PO antihistamines. EXAM Tinea Corporis - ANSWER>>ring like itchy rash, slowly enlarge central clearing"-Treatment: most respond to topical antifungals, if severe do oral Lamisil. EXAM AZOLE ending Cellulitis - ANSWER>>Deep dermis poor demarcated low legs. EXAM/ MULTIPLE QUESTIONS. DVT RISK, DM WITH CELLULITIS WATCH FOR OSTEOMYLITIS. Erysipelas - ANSWER>>Group A strep, painful, Upper dermis, clear demarcated, cheeks, shins. TREATMENT- Dicloxacillin QID x10d. Cephalexin, Clinda. PCN ALLERGY? Do Azithro x5d. MRSA TREATMENT: Bactrim, doxy, mino, clinda. If sulfa allergy do not use Bactrim. Varicella Zoster - ANSWER>>"contagious 48 h. before, until all lesions crusted over" low grade fever, generalized lymphadenopathy, intense itching, erythematous macules, papules develop over macules, then vesicles erupt. "initially on trunk, then scalp and face" TREATMENT supportive, antihistamines, acyclovir 20mg/kg 5xd. If given first 24 hours works best. EXAM Impetigo - ANSWER>>Impetigo-Gram positive. Itchy pink-red lesions, evolve into vesiculopustules that rupture. If bullous-large blisters. Severe- Keflex, dicloxacillin. PCN Allergic-Azithro, clinda. If NO BULLAE- Bactroban. EXAM Scarlet fever- scarlantina - ANSWER>>"sandpaper textured-pink rash with sore throat" strawberry tongue, rash starts on head and neck, spreads to trunk. The skin THEN desquamates. EXAM Lichen planus - ANSWER>>LICHEN PLANUS: SMALL FLAT TOPPED, RED TO PURPLE BUMPS THAT MAY HAVE WHITE SCALES/FLAKES.. WHISPY GREY WHITE STREAKS CALLED WICHHAMS STRIAE. INNER WRISTS FOREARMS, AND ANKLES. IF ON SCALP CAUSE HAIR LOSS. Causes hep C, medications, contact with chemicals. EXAM Spider bite - ANSWER>>fever chills, n/v, located arms, upper legs, or the trunk. Biten area becomes swollen, red, and tender, and blisters appear within 24-48 hours. Necrotic in center, which kills the tissue. Ice packs to wound and cold inactivates the toxin, tx like cellulitis of the skin, abx ointment at first, watch etc. Exam Pityoris rosea - ANSWER>>Pityoris rosea itchy, herald patch, xmas tree pattern, rash hands soles/feet think to test for secondary syphilis RPR then VDRL are screening, then dx FTA-ABS. EXAM Corneal abrasion - ANSWER>>Corneal Abrasions- Round/Irregular. Was on EXAM. Acute Angle Closure Glaucoma - ANSWER>>acute/severe halos, cupping optic nerve, cloudy cornea, mid- dilated oval pupil. ER STAT. EXAM Conductive - ANSWER>>Conductive: Lateralization to bad ear. Rinne- BC > AC. Rinne (1st mastoid, 2 front of ear, time each area). Weber: Tunning fork midline. CN 8 (acoustic). EXAM Koplik spots - ANSWER>>Koplik Spots- "clusters sm. Size red papules w/ white centers in the buccal mucosa by lower molars". Rubeolla. Fever, conjunctivitis, coryza, cough (3c). Morbiliform rash. EXAM Sensorineural - ANSWER>>Sensorineural: Lateralization to good ear. Rinne- AC > BC. OME - ANSWER>>Ear pressure, popping, muffled hearing, chronic allergic rhinitis, sterile serious fluid is trapped in the middle ear. TM should NOT BED RED. TM may bulge or retract. TREATMENT: Oral decongestants, steroid nasal spray, treat like allergies. Usually Painless. Weber- Lateralization to affected ear. Rhinne- BC > AC. PRECEDES OR USUALLY FOLLOWS AOM. SUPPORTIVE CARE AND WAIT 3 MOS SOMEX. EXAM Presbycusis - ANSWER>>sensorineural loss without lateralization. Involves the inner ear. Symmetrical progressive. Human speech lost first. AGING ADULT EXAM OE - ANSWER>>Otitis Externa (swimmers ear)- Pseudomonas aeruginosa. (other- S. aureus). External ear pain- d/c itching, hearing loss, tragus, green d/c. TREATMENT: Corticosporin, Cipro EXAM Sinusitis - ANSWER>>TX AMOXICILLIN OR AUGMENTIN ALLERGY MACROLIDE Meiniers disease - ANSWER>>VERTIGO TINNITUS, HEARING LOSS. nystagmas Mono - ANSWER>>test heterophile antibody test. ON EXAM MR. ASS - ANSWER>>(Systolic Murmur) Only systolic murmurs will radiate to a location on the exam. Mitral Regurg - ANSWER>>(Holo/pansystolic)- radiates to axilla. Think Mitral area 5th ics MCL. Aortic Stenosis (mid systolic ejection) radiates to neck. Think 2ics rsb. All diastolic murmurs are pathological. Grades Murmurs - ANSWER>>I-barely II-audible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM MVP - ANSWER>>MVP- S2 click, followed by systolic murmur. Asymptomatic. MVP with palpitations is treated with BB. LATE SYSTOLIC. S3- HF, S4-LVH stiffening, - ANSWER>>S3- HF, Kentucky, early diastole. Abn >35. Bell EXAM S4-LVH stiffening, Tennesse, late diastole. "Atrial kick/gallop" EXAM contraindicated renal and liver disease ARF creatinine up and GFR down. affects liver enzymes, weight loss, avoid in alcohol drinkers, lactic acidosis, diarrhea flatulence CT: hold 24 hr before and 48hr after Polycythemia vera - ANSWER>>slow growing blood cancer. blood too thick, clots. bone marrow to many RBC. risk bleed , anemia, CBC CCB - ANSWER>>BLE edema- walk around Kava Kava - ANSWER>>anxiety and insomnia, don't mix w sedating benzos. Bipolar med - ANSWER>>lithium- monitor TSH, toxicity bind to TH cause hypothyroidism. Depression med acute Anxiety/ panic med GAD med - ANSWER>>depression SSRI panic benzo, Xanax, ativan GAD SSRI SNRI- Buspar, Effexor, Cymbalta- Taper OFF SNRI/ Benzo Discontinuation - ANSWER>>Buspar, Effexor, Cymbalta and Benzo Taper OFF Thiazide GLUT- - ANSWER>>Glyceridemia Lipidemia Uricacidemia Triglyceridemia HYPO-Kalemia ACE/ARB contraindications - ANSWER>>pregnancy Renal failure Renal Stenosis METABOLIC SYNDROME - ANSWER>>METABOLIC SYNDROME NO THIAZIDES,CCB (HF) NO TZD ACTOS (Pioglitazone) GIVE Metformin, ACE or ARB- kidney protective, BB- causes hypoglycemia, Triglyceride < 300 what do we do first? Triglyceride in 300 plus risk for ___ what do we do? - ANSWER>>Lifestyle modification Pancreatitis, Niacin then add, fenofibrates Serotonin syndrome ss - ANSWER>>hyper rigidity, fever, myoclonus, dilated pupils, AMS, hyper reflexes, from SSRI or mix w MAOI and TCA NSAID contraindicated in - ANSWER>>HF and ARF increase BP impair renal prostaglandin and sodium retention strabismus - ANSWER>>misalignment of eyes, abnormal after 6 months macular degeneration - ANSWER>>loss of central vision retinal detachment - ANSWER>>floaters, curtain, flashes Xanthelasmas - ANSWER>>sharply demarcated yellowish deposit of cholesterol underneath the eye Red reflex absent - ANSWER>>retinoblastoma (leukorrhea) , cataracts, glaucoma. Will have white reflex Mono, return to play and Dx - ANSWER>>4-6 weeks when spleenolmegaly resolves Mono spot/ Heterophile Viral stomatitis - ANSWER>>ulcer on cheek (Aphthous)- viral canker sore cholesteatoma - ANSWER>>chronic sinusitis or OM. cauliflower, foul-smell, hearing loss. erodes bones in face affects facial CN 7. Benign- risk hearing loss refer SURGERY Acute Closed Angle Glaucoma Vs Open Angle - ANSWER>>Acute: Sudden pain, halos, cupping, dilated, cloudy , IOP, HA, refer ED Open (primary) : CN 2, gradual loss peripheral vision first Papilledema - ANSWER>>Swollen, optic disc, increase cup to disc ratio, HA, ICP, HTN, Acyclovir (cheapest) - ANSWER>>200mg 5 x day Pt on PPI, has osteoporosis has a cough, - ANSWER>>refer for EGD r/o Barrett's. allergic rhinitis - ANSWER>>blue pale turbinate clear drainage. Tx inhaled corticosteroids hordeolum Vs chalazion