FNP LEIK COMPREHENSIVE TEST PAPER
QUESTIONS AND SOLUTIONS
●● Specificity
Answer: (SPIN) Positive results rules in the disease.
●● Primary Prevention
Answer: Prevent the disease in its entirety. Examples include healthy
diet, exercise, safety (helmets/seatbelts), immunizations, and job safety
●● Secondary Prevention
Answer: Early detection of a disease. Examples include screening tests
●● Tertiary Prevention
Answer: Rehabilitation of a disease. Examples include support groups,
education for pts with pre-existing disease, drug side effect safety,
medical equipment safety, any type of rehab like PT or OT
●● Breast Cancer Screening Guidelines (USPSTF)
Answer: Onset = 50yo. Biannual. Stop at age 74yo. No SBE.
●● Breast Cancer Screening Guidelines (ACA)
,Answer: Onset = 40yo. Annual. No stop age.
●● Cervical cancer screening guidelines
Answer: Onset=21yo (immunocompromised individuals start at onset of
sexual activity). Every 3 years Pap w/ no HPV test until 30yo. Pap and
HPV test after 30 yo and can begin screening every 5 years. Stop at age
65yo. Complete hysterectomy means no Pap unless pt has history of
cervical cancer or high grade lesion.
●● Colorectal cancer
Answer: Onset 50yo. 1) colonoscopy q 10 years if wnl, 2)
sigmoidoscopy q 5 years if wnl, 3) annual FOBT with 3 stool samples.
Stop age 75 yo.
●● Prostate cancer
Answer: USPSTF does not recommend screening with PSA but it based
on individual pt.
●● Lipid screening
Answer: Onset 18-35/45yo screen if at increased risk of heart disease.
Males >35yo and Females >45yo
●● Flu vaccine
,Answer: LAIV - Live virus can only be given to healthy non-pregnant 2
-49 yo w/o recent hx of asthma (Peds). Cautioned in pts with egg,
gentamicin or gelatin allergy and kids receiving aspirin therapy (Reye's
syndrome). TIV (trivalent inactivated vaccine) is approved for
>6months.
●● Tetanus vaccine
Answer: Q 10 years. Booster for dirty wounds if last TDAP/Td is > 5
years old. >7yo receive Td/TDAP. Avoid in egg allergy and Gullian
Barre. 5 doses of DTAP aka Pediarix (2,4,6,15 months and 5 yo) First
TDAP is at age 11-12yo. Td is the booster every 10 years or if someone
has never had TDAP (came out in 2005) then they should have a one
time dose of TDAP and then continue with Td boosters.
●● Pneumococcal vaccine
Answer: PCV 23 given one time at age 65 yo in healthy adults and for
persons who are 2 years and older and at high risk for pneumococcal
disease (e.g., those with sickle cell disease, HIV infection, or other
immunocompromising conditions). PPSV23 is also recommended for
use in adults 19 through 64 years of age who smoke cigarettes or who
have asthma. One time booster given 5 years after first dose (So non-
healthy pts will receive 2 doses of PSV23 over their lifetime). PCV 13 is
for <5 yo. When both PCV13 and PPSV23 are indicated, PCV13 should
be administered first; PCV13 and PPSV23 should not be administered
during the same visit. When indicated, PCV13 and PPSV23 should be
administered to adults whose pneumococcal vaccination history is
incomplete or unknown.
, ●● Varicella Vaccine
Answer: 60 yo. May be given to pts who have previously had shingles.
May be given earlier at age 50yo. Live virus so c/I include pregnancy
and immunocompromised.
●● Herpes Keratitis
Answer: Inflammation of the cornea. C/O abrupt severe eye pain,
photophobia and blurred vision. Diagnose with fluorescein dye and
black lamp. Look for fernlike lines (corneal abrasions appear more
linear). Infection permanently damages corneal epithelium which may
result in blindness.
●● Acute angle closure
Answer: Glaucoma (Increased ICP r/t blocked drainage duct). Elderly pt
c/o abrupt onset of severe eye pain, HA, N/V, halos around eyes, and
decreased vision. Exam reveals mid-dilated pupil that is oval shaped,
cloudy cornea, and fundoscopic exam shows cupping of the optic nerve.
Tx = keep pt supine, trx to ED for acetazolamide, B blockers, and
topical steroids. Sx may be required
●● Cholesteatoma
Answer: Cauliflower like growth in the middle ear. Pt c/o foul smelling
discharge and hearing loss. On exam, no TM or ossicles visible. PMhx
of chronic OM. The mass is not cancerous but it can erode in to the
QUESTIONS AND SOLUTIONS
●● Specificity
Answer: (SPIN) Positive results rules in the disease.
●● Primary Prevention
Answer: Prevent the disease in its entirety. Examples include healthy
diet, exercise, safety (helmets/seatbelts), immunizations, and job safety
●● Secondary Prevention
Answer: Early detection of a disease. Examples include screening tests
●● Tertiary Prevention
Answer: Rehabilitation of a disease. Examples include support groups,
education for pts with pre-existing disease, drug side effect safety,
medical equipment safety, any type of rehab like PT or OT
●● Breast Cancer Screening Guidelines (USPSTF)
Answer: Onset = 50yo. Biannual. Stop at age 74yo. No SBE.
●● Breast Cancer Screening Guidelines (ACA)
,Answer: Onset = 40yo. Annual. No stop age.
●● Cervical cancer screening guidelines
Answer: Onset=21yo (immunocompromised individuals start at onset of
sexual activity). Every 3 years Pap w/ no HPV test until 30yo. Pap and
HPV test after 30 yo and can begin screening every 5 years. Stop at age
65yo. Complete hysterectomy means no Pap unless pt has history of
cervical cancer or high grade lesion.
●● Colorectal cancer
Answer: Onset 50yo. 1) colonoscopy q 10 years if wnl, 2)
sigmoidoscopy q 5 years if wnl, 3) annual FOBT with 3 stool samples.
Stop age 75 yo.
●● Prostate cancer
Answer: USPSTF does not recommend screening with PSA but it based
on individual pt.
●● Lipid screening
Answer: Onset 18-35/45yo screen if at increased risk of heart disease.
Males >35yo and Females >45yo
●● Flu vaccine
,Answer: LAIV - Live virus can only be given to healthy non-pregnant 2
-49 yo w/o recent hx of asthma (Peds). Cautioned in pts with egg,
gentamicin or gelatin allergy and kids receiving aspirin therapy (Reye's
syndrome). TIV (trivalent inactivated vaccine) is approved for
>6months.
●● Tetanus vaccine
Answer: Q 10 years. Booster for dirty wounds if last TDAP/Td is > 5
years old. >7yo receive Td/TDAP. Avoid in egg allergy and Gullian
Barre. 5 doses of DTAP aka Pediarix (2,4,6,15 months and 5 yo) First
TDAP is at age 11-12yo. Td is the booster every 10 years or if someone
has never had TDAP (came out in 2005) then they should have a one
time dose of TDAP and then continue with Td boosters.
●● Pneumococcal vaccine
Answer: PCV 23 given one time at age 65 yo in healthy adults and for
persons who are 2 years and older and at high risk for pneumococcal
disease (e.g., those with sickle cell disease, HIV infection, or other
immunocompromising conditions). PPSV23 is also recommended for
use in adults 19 through 64 years of age who smoke cigarettes or who
have asthma. One time booster given 5 years after first dose (So non-
healthy pts will receive 2 doses of PSV23 over their lifetime). PCV 13 is
for <5 yo. When both PCV13 and PPSV23 are indicated, PCV13 should
be administered first; PCV13 and PPSV23 should not be administered
during the same visit. When indicated, PCV13 and PPSV23 should be
administered to adults whose pneumococcal vaccination history is
incomplete or unknown.
, ●● Varicella Vaccine
Answer: 60 yo. May be given to pts who have previously had shingles.
May be given earlier at age 50yo. Live virus so c/I include pregnancy
and immunocompromised.
●● Herpes Keratitis
Answer: Inflammation of the cornea. C/O abrupt severe eye pain,
photophobia and blurred vision. Diagnose with fluorescein dye and
black lamp. Look for fernlike lines (corneal abrasions appear more
linear). Infection permanently damages corneal epithelium which may
result in blindness.
●● Acute angle closure
Answer: Glaucoma (Increased ICP r/t blocked drainage duct). Elderly pt
c/o abrupt onset of severe eye pain, HA, N/V, halos around eyes, and
decreased vision. Exam reveals mid-dilated pupil that is oval shaped,
cloudy cornea, and fundoscopic exam shows cupping of the optic nerve.
Tx = keep pt supine, trx to ED for acetazolamide, B blockers, and
topical steroids. Sx may be required
●● Cholesteatoma
Answer: Cauliflower like growth in the middle ear. Pt c/o foul smelling
discharge and hearing loss. On exam, no TM or ossicles visible. PMhx
of chronic OM. The mass is not cancerous but it can erode in to the
