ANCC review UPDATED Actual Questions
and CORRECT Answers
Metformin - CORRECT ANSWER- ✔✔rare risk of lactic acidosis, often occures w/ impaired
renal fx, hypovolemia, low perfusion, advanced age. hold during surgery or imaging w/
radiocontrast the day of and 48 hrs post.
lisinopril - CORRECT ANSWER- ✔✔cat d drug in pregnancy
teenager w/ menorrhagia who cant insert tampons - CORRECT ANSWER- ✔✔mirena IUD
best choice
(copper increases bleeding, implant increases bleeding)
tension headaches - CORRECT ANSWER- ✔✔bilateral. moderate pressing pain, recurring.
no photophobia or nausea.
prevent recurrence - TCAs (SE weight gain, drowsiness, dry mouth)
LNG-IUD - CORRECT ANSWER- ✔✔casues endometrial atrophy, 50% of users have
amenorrhea by end of 2 years. fertility returns soon after removal. progestin conrtibutes to
thickening og cervical mucus. minimizes upper reproductive rtact infections. atrophy
prevents impantation of ovum.
COCs - CORRECT ANSWER- ✔✔reduce menstrual volume by 60%
copper IUD - CORRECT ANSWER- ✔✔increases menstrual bleeding and may contribute to
increase in upper reproductive rtact infections.
BPH. which tests to assess degree of voiding dysfunction - CORRECT ANSWER-
✔✔residual volume and urine flow rates- non invasive so immediate testing.
,rectal US - prostate size and weight
cystography and retrograde and voiding urethrography - eval of bladder or urethral
diverticula
cytourethroscopy - confirm presence and effects of bladder neck obstruction d/t BPH
urethral stricture - CORRECT ANSWER- ✔✔c/o urinary dribbling after voiding, urge
incontinence, hx of STI
can result from infection, injuries (falling off bike), post surgical procedures. more common
in men <45.
pelvic floor weakness - stress incontinence
detrusor overactivity and UTI - urge incontinence
prilosec - CORRECT ANSWER- ✔✔can decrease mg
Meningitis - CORRECT ANSWER- ✔✔brudzinski sign
kernig sign
appendicitis - CORRECT ANSWER- ✔✔McBurney's Point - point bt umbilicus and
anteriosuperior iliac spine (find maximal amount of tenderness)
Obturator sign - pain w/ passive flexion and internal rotation of the right hip, indicative of
peritoneal irritation
Psoas sign - pain on passive extension of the right hip, illicit by having pt lay straight and
raise right leg against resistance
,Rovsing's sign - pain elicited by palpating LLQ
CT best dx tool
MCL - CORRECT ANSWER- ✔✔Valgus stress test (gum, push knee in)
LCL - CORRECT ANSWER- ✔✔varus stress test
ACL - CORRECT ANSWER- ✔✔lachman and anterior drawer
audible pop at injury
Meniscus - CORRECT ANSWER- ✔✔mcmurray, thessaly, apley
rotational pain
hip flexed, knee externally rotated as knee is moved from full flexion to extension. snap
heard or felt suggests tear.
Thessaly test
(meniscus) - CORRECT ANSWER- ✔✔•pt standing and facing dr while holding
hands/shoulders to stablize them
•stand on one leg, initially have knee relaxed (*this is about 5° of flexion*)
•then tell them to rotate about their knee (internal/external) about 3x and "let me know if this
causes or changes your sx"
•If negative at 5°, have them flex slightly more to just 20° and repeat.
•do bilaterally
(+) pain, joint line clicking and/or sense of locking/catching
, ind: lateral P = lateral meniscus issue or medial P = medial meniscus issue
mild acne - CORRECT ANSWER- ✔✔open comedones (blackheads), closed comedones
(noninflammatory acne) w/ or w/o small papules
tx - topicals only
rx meds - retin A, benzoyl peroxide w/ erytheomycin, clindamycin (start lowest does, qod)
moderate acne - CORRECT ANSWER- ✔✔papules, pustules, inflamatory lesions w/
comodomes
tx
continue w/ topical for mild acne
add oral abt - tetracyclin, minocycline, doxycycline, erythromycin, clindamycin
tetracycline - can start at age 13 w/o risk to tooth discoloration, cat d in pregnancy, need
backup contraceptive
OCs - yaz, desogen
diet - limit dairy
severe acne - CORRECT ANSWER- ✔✔plus painful nodules, cysts, abscesses and pustules
over face shoulders, chest
tx
accutane - cat x PLEDGE program
2 forms of reliable contraception
and CORRECT Answers
Metformin - CORRECT ANSWER- ✔✔rare risk of lactic acidosis, often occures w/ impaired
renal fx, hypovolemia, low perfusion, advanced age. hold during surgery or imaging w/
radiocontrast the day of and 48 hrs post.
lisinopril - CORRECT ANSWER- ✔✔cat d drug in pregnancy
teenager w/ menorrhagia who cant insert tampons - CORRECT ANSWER- ✔✔mirena IUD
best choice
(copper increases bleeding, implant increases bleeding)
tension headaches - CORRECT ANSWER- ✔✔bilateral. moderate pressing pain, recurring.
no photophobia or nausea.
prevent recurrence - TCAs (SE weight gain, drowsiness, dry mouth)
LNG-IUD - CORRECT ANSWER- ✔✔casues endometrial atrophy, 50% of users have
amenorrhea by end of 2 years. fertility returns soon after removal. progestin conrtibutes to
thickening og cervical mucus. minimizes upper reproductive rtact infections. atrophy
prevents impantation of ovum.
COCs - CORRECT ANSWER- ✔✔reduce menstrual volume by 60%
copper IUD - CORRECT ANSWER- ✔✔increases menstrual bleeding and may contribute to
increase in upper reproductive rtact infections.
BPH. which tests to assess degree of voiding dysfunction - CORRECT ANSWER-
✔✔residual volume and urine flow rates- non invasive so immediate testing.
,rectal US - prostate size and weight
cystography and retrograde and voiding urethrography - eval of bladder or urethral
diverticula
cytourethroscopy - confirm presence and effects of bladder neck obstruction d/t BPH
urethral stricture - CORRECT ANSWER- ✔✔c/o urinary dribbling after voiding, urge
incontinence, hx of STI
can result from infection, injuries (falling off bike), post surgical procedures. more common
in men <45.
pelvic floor weakness - stress incontinence
detrusor overactivity and UTI - urge incontinence
prilosec - CORRECT ANSWER- ✔✔can decrease mg
Meningitis - CORRECT ANSWER- ✔✔brudzinski sign
kernig sign
appendicitis - CORRECT ANSWER- ✔✔McBurney's Point - point bt umbilicus and
anteriosuperior iliac spine (find maximal amount of tenderness)
Obturator sign - pain w/ passive flexion and internal rotation of the right hip, indicative of
peritoneal irritation
Psoas sign - pain on passive extension of the right hip, illicit by having pt lay straight and
raise right leg against resistance
,Rovsing's sign - pain elicited by palpating LLQ
CT best dx tool
MCL - CORRECT ANSWER- ✔✔Valgus stress test (gum, push knee in)
LCL - CORRECT ANSWER- ✔✔varus stress test
ACL - CORRECT ANSWER- ✔✔lachman and anterior drawer
audible pop at injury
Meniscus - CORRECT ANSWER- ✔✔mcmurray, thessaly, apley
rotational pain
hip flexed, knee externally rotated as knee is moved from full flexion to extension. snap
heard or felt suggests tear.
Thessaly test
(meniscus) - CORRECT ANSWER- ✔✔•pt standing and facing dr while holding
hands/shoulders to stablize them
•stand on one leg, initially have knee relaxed (*this is about 5° of flexion*)
•then tell them to rotate about their knee (internal/external) about 3x and "let me know if this
causes or changes your sx"
•If negative at 5°, have them flex slightly more to just 20° and repeat.
•do bilaterally
(+) pain, joint line clicking and/or sense of locking/catching
, ind: lateral P = lateral meniscus issue or medial P = medial meniscus issue
mild acne - CORRECT ANSWER- ✔✔open comedones (blackheads), closed comedones
(noninflammatory acne) w/ or w/o small papules
tx - topicals only
rx meds - retin A, benzoyl peroxide w/ erytheomycin, clindamycin (start lowest does, qod)
moderate acne - CORRECT ANSWER- ✔✔papules, pustules, inflamatory lesions w/
comodomes
tx
continue w/ topical for mild acne
add oral abt - tetracyclin, minocycline, doxycycline, erythromycin, clindamycin
tetracycline - can start at age 13 w/o risk to tooth discoloration, cat d in pregnancy, need
backup contraceptive
OCs - yaz, desogen
diet - limit dairy
severe acne - CORRECT ANSWER- ✔✔plus painful nodules, cysts, abscesses and pustules
over face shoulders, chest
tx
accutane - cat x PLEDGE program
2 forms of reliable contraception
