AANP FNP CERTIFICATION DIFFERENT VERSION, Exams of Nursing

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AANP FNP CERTIFICATION DIFFERENT VERSION

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All diastolic murmurs are pathological. Murmurs Grades I-barely IIaudible III- clearly audible. IV- first time thrill V-Steth edge VI-entire steth. EXAM - ---CORRECT ANSWER-->III first time audible, IV first time thrill Fundal height 12 weeks - ---CORRECT 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? - ---CORRECT ANSWER-->Iron, TIBC

3 months of synthroid, TSH increased, T4 normal, what do you do? - CORRECT ANSWER-->Increase Medication 3 ways to assess cognitive function in patient with signs/symptoms of memory loss - ---CORRECT ANSWER-->Mini mental exam 4 month old with strabismus, mom is worried...... - ---CORRECT ANSWER-->tell her it is normal. 4 month old wont keep anything down, what is the main thing you look at? - ---CORRECT ANSWER-->Growth chart 6 month old closed anterior fontanel. - ---CORRECT ANSWER-->XRAY Abnormal cells on PAP, what do you do next? - ---CORRECT ANSWER>Refer for Colposcopy CAGE ACRONYM - ---CORRECT ANSWER-->Cut down Annoyed by criticism Guilty about drinking Eye opener drink Causes of tachycardia - ---CORRECT ANSWER-->Fever Anemia Hypotension Cranial nerves responsible for extraocular eye movements - ---CORRECT

Koplick spots - ---CORRECT ANSWER-->Measles (rubeola). Grains of salt lesions inside mouth in Measles Koplick spots - ---CORRECT ANSWER-->Measles (rubeola). Grains of salt lesions inside mouth in Measles Legg-Calve-Perthes Disease - ---CORRECT ANSWER-->Avascular necrosis of the proximal femoral head Lipid level of 1500, increased risk for? - ---CORRECT ANSWER>Pancreatitis Low HGB, Low HCT, High MCV indicates what? - ---CORRECT ANSWER>Macrocytic anemia, B12 Def Man with BPH, prostate feels on digital exam? - ---CORRECT ANSWER--

Enlarged, symmetrical, smooth Man with HTN, CAD, present femoral pulses but absent pedal - -- CORRECT ANSWER-->Arterial Insufficiency McMurray's Sign (+) palpable or audible click while extending with varus stress - CORRECT ANSWER-->Meniscus tears Lachman's Test - ---CORRECT ANSWER-->pivot shift test (ACL tear)

Newborn with foot turned in, what do you do? - ---CORRECT ANSWER>refer to orthopedist Osgood-Schlatter disease - ---CORRECT 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? - ---CORRECT 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? - ---CORRECT ANSWER-->Refer to oncologist Pt presents with rash on shoulder, erythematous maculopapular rash with center clearing and scaling? - ---CORRECT ANSWER-->Tinea Corporis Pt presents with "bag of worms:, indicates? - ---CORRECT ANSWER>Varicocele Pt with atopic dermatitis, look for what other diseases? - ---CORRECT ANSWER-->Asthma Pt with bleeding after menopause - ---CORRECT ANSWER-->endometrial biopsy, need to screen for cancer

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: - ---CORRECT ANSWER-->12 step program Treatment for Gonorrhea? - ---CORRECT 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: - ---CORRECT ANSWER-->IUD Basal cell cancer - ---CORRECT ANSWER-->Waxy, pearly, telangiectasia, ulcer center lesion
• most common type of skin cancer caused by UV exposure. Metastatic is rare

Actinic Keratosis - ---CORRECT ANSWER-->Scaly red to yellow located in sun exposed area

• a precancerous skin growth that occurs on sun-damaged skin Actinic Keratosis - ---CORRECT 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 - ---CORRECT ANSWER-->Make a hole and drain the blood Moderate acne treatment - ---CORRECT 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

, 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. - - CORRECT 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 - ---CORRECT ANSWER-->Smoking cessation Pulmonary rehabilitation

Pharmacologic therapy Supplemental oxygen TB... PPD is positive if area of induration is: - ---CORRECT ANSWER-->> 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. - CORRECT ANSWER-->Croup/Epiglottitis AV nicking (Arterioles pressing on vein of the eye) - ---CORRECT ANSWER-->HTN retinopathy intraocular pressure (IOP) - ---CORRECT ANSWER-->Fluid pressure inside the eye; measured with tonometry Rovsing sign - ---CORRECT ANSWER-->pain in the RLQ when the LLQ is palpated (indicative of appendicitis) Pencil-like stools occur in an obstruction of what - ---CORRECT ANSWER-->Sigmoid descending colon It's a thin narrow stool and possible causes include colon cancer, diarrhea, IBS. Refer for GI colonoscopy

abortive triptans prophylaxis propranolol, TCA amitriptyline, anticonvulsants topiramate Vitamin B12 - ---CORRECT ANSWER-->Folate shares a close relationship with this other B Vitamin. Vitamin B12 - ---CORRECT 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. - ---CORRECT ANSWER-->be changed to NSAID, SED rate is a sign of inflammation Which medication causes low sperm count for a patient - ---CORRECT ANSWER-->SSRI grandiosity - ---CORRECT ANSWER-->Exaggerated belief in or claims about one's importance or identity. Bipolor

ADHD - ---CORRECT ANSWER-->A behavioral problem characterized by short attention span, restless movement, and impaired learning capacity.

pt. expericieng memory loss, and increase in confusion and she has a history of stroke, HTN, What type of Alzheimer. - ---CORRECT ANSWER-

• vascular dementia presbycusis - ---CORRECT 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 - ---CORRECT ANSWER-->Ultrasound Romberg test - ---CORRECT 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 - ---CORRECT ANSWER-->r/o bilirubin preeclampsia treatment - ---CORRECT ANSWER-->bed rest, laying on her side Molluscum contagiosum treatment - ---CORRECT ANSWER-

Currettage, liquid nitrogen pyloric stenosis - ---CORRECT 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 - ---CORRECT ANSWER-->Ménière's disease? Nystagmus test - ---CORRECT 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. - ---CORRECT ANSWER-->sialolithiasis). Etopic Pregnancy: Risk Factors - ---CORRECT 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 - ---CORRECT ANSWER-->Options include (low oxygen, high oxygen, hypercapnia, hypocapnia)? Which among the list can cause increase in respiration - ---CORRECT ANSWER-->hypercapnia

hormones, obesity, pregnancy, smoking, theophylline, exacerbated by CCB verapamil Common causes of GERD - ---CORRECT 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 - ---CORRECT ANSWER-->CAUSES ELEVATED LIPDS, GLUCOSE, WEIGHT monitor CBC for low WBC weight- BMI q 3m b/p, mental status, lips, prolactin, glucose Weber test - ---CORRECT 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 - ---CORRECT 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 - ---CORRECT ANSWER-->Dullness Assessment on patient with ascites - ---CORRECT ANSWER-->Dullness to percussion Varus Stress Test - ---CORRECT 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 - ---CORRECT 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 German Measles (Rubella) - ---CORRECT ANSWER-->Pink, papular rash (similar to measles but paler) first appears on face, then spreads. Distinguished from measles by presence of neck lymphadenopathy and absence of Koplik spots. patient with IOP of 32mmHg, what do you expect during fundoscopic exam - ---CORRECT ANSWER--> patient with IOP of 32mmHg, what do you expect during fundoscopic exam - ---CORRECT ANSWER-->increase cup-to-disc ratio retinal hemorrhage optic nerve asymmetry and pallor measured w tonometry