ACNN Exam Bank 2026/2027 | Verified Questions & Answers | ANCC
Nurse Practitioner Certification Study Guide | Advanced Pharmacology,
Clinical Practice, Primary Care & Board Review | Graded A+
Types of prevention - ANSWER primary- car restraints, bicycle helmets, immunizations
secondary- prevent for those with RF-pap, mammo
tertiary-mgmt of established disease- meds, lifestyle
Primary - ANSWER Preventing the health problem, most cost effective form of healthcare
**IMMUNIZATIONS, ensuring adequate illumination at home (preventing falls)
Secondary - ANSWER Detecting disease in early asymptomatic stages, screenings
-Early cause finding of asymptomatic disease via the use of a screening test
Ex. highly abnormal mammo not final word
Tertiary - ANSWER Minimizing negative disease induced outcomes, potentially viewed as a failure of
primary prevention
Ex- rehab, PT, OT
Who should not receive influenza vaccine - ANSWER 4 mon old born at 32 weeks gestation
receive flu- 6 mon and older
can give during pregnancy/lactation
give children 2x- 4 months apart
MMR - ANSWER preggers can't receive (no varicella, or zoster, smallpox, flu mist, rotavirus), but
lactation OK!
its live but weakened
give again to those born after 1957
Give to 6-11 month who are travelling outside US
May treat and have an innocent flat pink rash
,2 doses ( at 12-15 mon and 4-6 years)
Tetanus - ANSWER can get from soil, a depth of the wound is important
Preggers- get a tdap in her thirst trimester to pass onto the unborn child (pertusis is a bad outcome!),
family members need to be up to date- can cause lockjaw
T-dap- 1 at 11-64 and then booster every 10
dTap-five doses
Pertussis- uncontrollable cough, vomitting, fatigue, dx: nasopharyngeal culture and PCR testing
tx: Azithromycin
No pap smear - ANSWER prior to 21 or in elderly
Benadryl - ANSWER older, cross BBB, can cause sedation, urinary retention (bad for BPH)
herpes zoster - ANSWER stronger chickenpox vaccine-zoster vaccine
post-herpetic neuralgia- persists after 1 month
Herpes keratitis is damage to the corneal epithelium caused by the herpes virus, commonly shingles.
The patient usually has acute onset of eye pain, photophobia, and blurred vision in the affected eye.
primary open angle glaucoma - ANSWER peripheral vision loss, elevated intraocular pressure, deep-
cupping of optic disc, tx with beta-adrenergic antag (Timolol), alpha agonists, prostaglandin
analogues
Glaucoma screening test- Tonometry
Normative aging - ANSWER Need for increased illumination
Macular degeneration - ANSWER central vision loss, common cause of new onset blindness in elderly
,More females
Screening tests- Amsler grid test
Meniere's disease (idio) vs. Meniere's syndrome (secondary) - ANSWER dizziness, tinnitius,
nystagmus, vertigo RF: ototoxic drugs, tx: benzos for rest and corticosteroids for anti-inflam
oral cancer - ANSWER ulcerated lesion with indurated margins, most common SCC, RF: HPV 16,
screening at dental visits
beta lacatams with allergic reactions - ANSWER penecillins, cephalosporins, carbapenems
rashes with Epstein Barr
Otitis externa - ANSWER Caused by fungus- Candidia or Aspergillus/P. aeruginosa
hallmark is pain on palpating tragus
Tx--> fluoroquinolone
AOM - ANSWER S.penumoniae (gram pos)-40-50%, tx with amox/cephalo, macrolides, resistance
protein binding sites
H.influenza (gram neg)- can produce beta-lactamase
M.catarrhalis (gram neg)- also produces beta-lactamase, can get better without antibiotic
Need abnormal ear drum (bulging TM) + pain (otalgia)/rubbing/tugging ear
tx- Acetaminophen and otic drops help with ST
Watchful waiting- 6 months or older, with non-severe illness, unilateral, fever <102.2, otalgia <48
<6 months-begin antibiotic!! if allergy-Cefdinir], RF: pacifier use for 10 months, feedings in the
supine, smoke exposure, day care,
<2- 10 days
2-6 yrs- 7 days
, >6 yrs- 5 days
1st line- Amox 90 BID, Amox clav BID
With PCN allergy- **Cefdinir (Cephlosporins)
Group A strep
(GABHS) - ANSWER Streptococcus pyogenes, risk for rheumatic fever and Glomerulo., peritonsillar
abscess,
tx- amox then try macrolide if doesnt't improve
GOLD STANDARD IS THROAT CULTURE
indoor allergen - ANSWER dust mites (perennial), pets, cockroaches, mold spores
Acute Bacterial rhinosinusitis - ANSWER S.penumoniae**, RF-viral infection, allergies, tobacco use,
1st line is Augmentin, penicillin allergy-Cefdinir
2nd line- if not better...Clindamycin and Cefixime
Mono - ANSWER 30-50 days ago was infected before sxs, give prednisone not amox (rash), at least
50% present with spleen enlargement, wait 1 month to go back to sports
Anterior and posterior cervical lymph
Pharyngitis with exudate
right and left upper quadrant abdominal tendernes
Hepatomegaly in 10% of cases
Splenomegaly in 50% of cases
Asthma flare - ANSWER FEV1/Peak expiratory flow rate- drops early (even before patient notices)
and good indication of severity of asthma
S3 - ANSWER systolic dysfunction or early diastolic, common in HF (dyspnea, crackles, tachycardia- 3
adject/s3),
Nurse Practitioner Certification Study Guide | Advanced Pharmacology,
Clinical Practice, Primary Care & Board Review | Graded A+
Types of prevention - ANSWER primary- car restraints, bicycle helmets, immunizations
secondary- prevent for those with RF-pap, mammo
tertiary-mgmt of established disease- meds, lifestyle
Primary - ANSWER Preventing the health problem, most cost effective form of healthcare
**IMMUNIZATIONS, ensuring adequate illumination at home (preventing falls)
Secondary - ANSWER Detecting disease in early asymptomatic stages, screenings
-Early cause finding of asymptomatic disease via the use of a screening test
Ex. highly abnormal mammo not final word
Tertiary - ANSWER Minimizing negative disease induced outcomes, potentially viewed as a failure of
primary prevention
Ex- rehab, PT, OT
Who should not receive influenza vaccine - ANSWER 4 mon old born at 32 weeks gestation
receive flu- 6 mon and older
can give during pregnancy/lactation
give children 2x- 4 months apart
MMR - ANSWER preggers can't receive (no varicella, or zoster, smallpox, flu mist, rotavirus), but
lactation OK!
its live but weakened
give again to those born after 1957
Give to 6-11 month who are travelling outside US
May treat and have an innocent flat pink rash
,2 doses ( at 12-15 mon and 4-6 years)
Tetanus - ANSWER can get from soil, a depth of the wound is important
Preggers- get a tdap in her thirst trimester to pass onto the unborn child (pertusis is a bad outcome!),
family members need to be up to date- can cause lockjaw
T-dap- 1 at 11-64 and then booster every 10
dTap-five doses
Pertussis- uncontrollable cough, vomitting, fatigue, dx: nasopharyngeal culture and PCR testing
tx: Azithromycin
No pap smear - ANSWER prior to 21 or in elderly
Benadryl - ANSWER older, cross BBB, can cause sedation, urinary retention (bad for BPH)
herpes zoster - ANSWER stronger chickenpox vaccine-zoster vaccine
post-herpetic neuralgia- persists after 1 month
Herpes keratitis is damage to the corneal epithelium caused by the herpes virus, commonly shingles.
The patient usually has acute onset of eye pain, photophobia, and blurred vision in the affected eye.
primary open angle glaucoma - ANSWER peripheral vision loss, elevated intraocular pressure, deep-
cupping of optic disc, tx with beta-adrenergic antag (Timolol), alpha agonists, prostaglandin
analogues
Glaucoma screening test- Tonometry
Normative aging - ANSWER Need for increased illumination
Macular degeneration - ANSWER central vision loss, common cause of new onset blindness in elderly
,More females
Screening tests- Amsler grid test
Meniere's disease (idio) vs. Meniere's syndrome (secondary) - ANSWER dizziness, tinnitius,
nystagmus, vertigo RF: ototoxic drugs, tx: benzos for rest and corticosteroids for anti-inflam
oral cancer - ANSWER ulcerated lesion with indurated margins, most common SCC, RF: HPV 16,
screening at dental visits
beta lacatams with allergic reactions - ANSWER penecillins, cephalosporins, carbapenems
rashes with Epstein Barr
Otitis externa - ANSWER Caused by fungus- Candidia or Aspergillus/P. aeruginosa
hallmark is pain on palpating tragus
Tx--> fluoroquinolone
AOM - ANSWER S.penumoniae (gram pos)-40-50%, tx with amox/cephalo, macrolides, resistance
protein binding sites
H.influenza (gram neg)- can produce beta-lactamase
M.catarrhalis (gram neg)- also produces beta-lactamase, can get better without antibiotic
Need abnormal ear drum (bulging TM) + pain (otalgia)/rubbing/tugging ear
tx- Acetaminophen and otic drops help with ST
Watchful waiting- 6 months or older, with non-severe illness, unilateral, fever <102.2, otalgia <48
<6 months-begin antibiotic!! if allergy-Cefdinir], RF: pacifier use for 10 months, feedings in the
supine, smoke exposure, day care,
<2- 10 days
2-6 yrs- 7 days
, >6 yrs- 5 days
1st line- Amox 90 BID, Amox clav BID
With PCN allergy- **Cefdinir (Cephlosporins)
Group A strep
(GABHS) - ANSWER Streptococcus pyogenes, risk for rheumatic fever and Glomerulo., peritonsillar
abscess,
tx- amox then try macrolide if doesnt't improve
GOLD STANDARD IS THROAT CULTURE
indoor allergen - ANSWER dust mites (perennial), pets, cockroaches, mold spores
Acute Bacterial rhinosinusitis - ANSWER S.penumoniae**, RF-viral infection, allergies, tobacco use,
1st line is Augmentin, penicillin allergy-Cefdinir
2nd line- if not better...Clindamycin and Cefixime
Mono - ANSWER 30-50 days ago was infected before sxs, give prednisone not amox (rash), at least
50% present with spleen enlargement, wait 1 month to go back to sports
Anterior and posterior cervical lymph
Pharyngitis with exudate
right and left upper quadrant abdominal tendernes
Hepatomegaly in 10% of cases
Splenomegaly in 50% of cases
Asthma flare - ANSWER FEV1/Peak expiratory flow rate- drops early (even before patient notices)
and good indication of severity of asthma
S3 - ANSWER systolic dysfunction or early diastolic, common in HF (dyspnea, crackles, tachycardia- 3
adject/s3),
